Repeated cannulation of children during the course of treatment is distressing for the child, their family and to their nurses. Some paediatric units endeavour to minimise recannulation by employing strategies to reduce complications such as phlebitis and thrombosis formation. One strategy is to infuse low dose heparin and hydrocortisone (HEPHC). However, its effectiveness in prolonging cannula survival is inconclusive. There is also concern about the potential risks of administering these preparations to children. A randomised, controlled, blinded trial was conducted that examined the effectiveness of continuous infusion of low dose HEPHC in a group of children requiring long term intravenous antibiotics in a general paediatric unit. Comparisons of cannula complications and cannulae survival times were made in children receiving either continuous infusions of clear fluids or low dose HEPHC. The results demonstrated that there was no statistically significant difference (Logrank statistic=l.l, p=0.3) in cannula survival times between the two groups. It was also found that the bacterial and fungal colonisation of cannula for these children was extremely low. Based on these findings it is recommended that routine administration of low dose HEPHC to extend cannula survival time be discontinued. The findings also support current practice of removing cannula in children only when a complication occurs on completion of treatment.

The primary clinical characteristics of cystic fibrosis (CF) are malnutrition caused by malabsorption secondary to pancreatic insufficiency, chronic pulmonary infections, and male infertility. The major cause of morbidity and mortality are bronchiectasis and obstructive pulmonary disease. Lung disease in CF is manifested by this chronic lung disease progression, with intermittent episodes of acute worsening of symptoms called pulmonary exacerbations. Once the patient has stabilized, and if suitable care can be arranged, these interventions are often transitioned to the home. This review summarizes important points pertinent to the use of intravenous and inhaled antimicrobials that may be encountered by prescribers, nurses, technicians, and case managers in the home health setting. Appropriate dosing, indications, adverse drug reactions, monitoring parameters, and practicality of both intravenous and inhaled antimicrobials are discussed.