Most Australian Paediatric centres still employ standard IFX infusions with little published data regarding rapid infusion protocols in paediatric practice. Aim: From a Tertiary Paediatric
IBD centre, we describe the practice and safety of rapid, 1 hour IFX infusion since implementing a rapid infusion policy in October 2011. Methods: Retrospective chart review of children diagnosed with Crohn’s Disease and fulfilling Australian criteria for Infliximab therapy attending the Royal Akt inhibitor Children’s Hospital, Brisbane from October 2011 to May 2013. The Rapid Infusion policy is to give the 3 Induction and 1st maintenance infusion in the standard fashion, increasing the rate to completion over 2.5 hours. All subsequent infusions, commencing with 5th infusion are given over 1 hour. Pre-medication (loratidine, hydrocortisone, paracetamol) is not routinely given, only after a documented infusion reaction. Results: 50 children have been treated using the rapid infusion policy and received 373 IFX infusions. No serious or anaphylactic reaction requiring adrenalin has been observed. 3 (6%) of children experienced a transfusion reaction (1 fever to 38oC; 1 mild temporary rash; 1 nausea) in 3/373 infusions (0.8%) but only during the first 3, induction, 2 hour infusions. No child experienced a transfusion reaction during subsequent rapid 1 hour infusions. check details Each child who experienced
a reaction has subsequently tolerated 1 hour rapid infusions, with premedication, without recurrence of transfusion reaction. There were no predictive factors for reaction. 50/50 children and their parents report satisfaction with the shorter duration infusion Aprepitant and shorter hospital stay. The Infusion centre has been able to increase
the number of children receiving Infliximab infusion at each session, improving timely access to scheduled therapy. Conclusions: This audit of practice confirms that the Rapid Infusion IFX protocol commencing at Infusion 5 and without routine pre-medication is safe, practical and well accepted by children and care-givers, improving patient acceptance and access to efficacious medication. Even faster infusions are described and safe in Adult practice and may provide further improvement in paediatric care and service delivery. (1) Donnellan FC et al. “Accelerated infliximab infusions are safe and well tolerated in patients with inflammatory bowel disease”. European Journal of Gastroenterology & Hepatology 2009:21(1):71–75 J KERR,1 A NAIR,2 R HINDS1,2 1Department of Paediatric Gastroenterology, Monash Children’s Hospital, Clayton, Victoria, Australia, 2Department of Paediatrics, Monash University, Clayton, Victoria, Australia Introduction: Infliximab (IFX) is commonly used in the management of children with Crohn’s disease (CD). IFX is used in Australia when there has been inadequate response to other treatments or in the presence of fistulising disease.