***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Many cystic fibrosis patients with Pseudomonas lung infections receive intravenous ( IV ) antibiotics and chest physiotherapy ( CPT ) at home . Previous studies have suggested that home care , in the setting of a clinical study , is as efficacious as hospital care . This report compares the outcomes of home care with minimal supervision to outcomes of hospital care . We compared two groups of similar age and severity of lung impairment . Patients met strict definitions for home or hospital treatment ( 27 home care courses/33 hospital care courses ) . Five patients completed six courses of both home care and hospital treatment .  Treatment in both groups included intravenous antibiotics and CPT . Primary outcome measures included changes in pulmonary function between the start of treatment and after 2 weeks of therapy , duration of treatment , and intervals between antibiotic courses . In hospitalized patients , forced vital capacity ( FVC ) increased by 17.4 + /- 3.1 % ( mean + /- SEM ) , and forced expiratory volume in one second ( FEV1 ) increased by 23.3 + /- 4.1 % , both significant at P < 0.001 . The FVC and FEV1 of patients treated at home increased by 10.2 + /- 2.0 % and 13.7 + /- 2.6 % respectively , neither of which was a significant improvement . Similar results were found in the five patients completing both home and hospital courses . The average duration of treatment was twice as long and time between IV antibiotic courses only two-thirds as long for those treated at home compared with the hospitalized patients . Previous reports have cl aim ed that home care in the setting of a prospect i ve study is as efficacious as hospital care . Our experience indicates that routine home care with minimal supervision of patients is less effective than hospital care . Furthermore , home care as delivered to patients in this report increased the overall cost of care by as much as 30 % because of longer and more frequent courses of antibiotic therapy Abstract . Background : Home intravenous antibiotic treatment has added to therapeutic options against Pseudomonas aeruginosa in cystic fibrosis ( CF ) patients leading to increased flexibility . A prospect i ve clinical study was carried out to compare home and hospital iv antibiotic treatment in CF patients with chronic P. aeruginosa infection . Patients and Methods : Treatment courses were planned selectively , exacerbations were excluded . 28 consecutive hospital courses ( group 1 ) were compared with 30 home care courses ( group 2 ) . Chest physiotherapy and nutrition therapy were carried on in both groups . Antibiotic treatment in both groups consisted of tobramycin and ceftazidime , with equal dosage and application . Groups were compared using clinical , inflammatory and microbiological parameters . Results : There was a significant difference ( p ≤ 0.05 ) in peripheral leukocyte counts before and after therapy in both groups . The same was true for forced expiratory volume in 1 sec ( FEV1 ; p ≤ 0.05 ) , weight for height ( p ≤ 0.005 ) and for Pseudomonas counts ( p ≤ 0.005 ) in sputa . There was no statistical difference between the two groups for any of the parameters tested . Conclusion : It is concluded that , when exacerbations are excluded , home iv therapy is an effective therapeutic option in CF . Long-term comparison is still needed to effectively evaluate the pros and cons of home and hospital antibiotic treatment in CF In this study , we set out to determine if home intravenous ( i.v . ) antibiotic therapy in adult patients with cystic fibrosis ( CF ) is a feasible , effective and less costly alternative to hospitalization , and to assess the impact of home therapy on quality of life . The study was a prospect i ve , r and omized , two-factor mixed design involving adults presenting with respiratory exacerbations of CF . Patients were r and omized such that they were discharged home after 2 - 4 days , or remained in hospital . Seventeen patients had 31 admissions ( 13 home and 18 hospital ) . Following 10 days of therapy , there were no significant differences between home or hospital arms with respect to body weight , 12 minute walking distance , sputum weight , pulse oximetry , or improvement in lung function ( forced expiratory volume in one second ( FEV1 ) , or forced vital capacity ( FVC ) ) . Patients who remained in hospital were less fatigued and noted a greater degree of mastery . Patients discharged early noted less disruption to their family life , personal life and sleeping pattern . The total cost for the home therapy arm was approximately half that of the hospital therapy arm . Home intravenous antibiotic therapy in patients with cystic fibrosis was a feasible , cost-effective alternative to receiving therapy in hospital . Although there was no clinical compromise associated with home therapy , there were advantages and disadvantages in terms of quality of life METHODS 14 patients with cystic fibrosis and chronic pulmonary pseudomonas infection received four courses of two-week intravenous antibiotic therapy at home and during hospitalisation over an 18-month period . Following a controlled , intra-individual cross-over design , two courses of home therapy were followed by two courses of hospital treatment or vice versa . Parameters for inflammation , lung function , and body mass index were obtained at the beginning and end of each intravenous antibiotic therapy .  Health-related quality of life , i.e. physical , emotional , social and functional components as well as happiness and medical care , was assessed at the end of each course . RESULTS There was a trend towards better reduction of infection ( p = 0.20 for leukocyte reduction ) and improvement of lung function ( p = 0.20 for FEV1 improvement ) with hospital intravenous antibiotic therapy , although the differences did not attain statistical significance . Quality of life during therapy was significantly higher with home therapy regarding social ( p < 0.01 ) , functional and emotional subscales and happiness ( all p < 0.05 ) . The necessity for professional help and support from family and /or partner was emphasised . Individual answers showed that home therapy has the advantage of self-determination and continuity of daily life . Parents and partners felt impaired by day and night intravenous therapy at home . CONCLUSION From our data we conclude that home intravenous antibiotic therapy is a useful option for a selected subgroup of patients with cystic fibrosis , but professional support and family aid is important to gain an effect similar to hospital treatment In a prospect i ve , r and omised , cross-over study including cystic fibrosis patients with indications for HIVAT ( home intravenous antibiotic treatment ) the prospect of pharmaceutical intervention was investigated . A comparison between the use of disposable infusion devices with antibiotics from the pharmacy and when the patients prepared the drugs themselves was performed . During a first treatment course the patients received either infusion devices during 5 days or reconstituted the drugs themselves during 5 days , or vice versa . During a second treatment course the order was the reversed . Eight patients were included , out of which six completed the original design as a cross-over study , yielding a total of 550 doses of antibiotics . The patients preferred infusion devices from the pharmacy prepared according to GMP ( Good Manufacturing Practice ) as opposed to reconstituting the antibiotics themselves . Points of view presented included no anxiety over the correct dosage of drugs and less disruption of family and social life . In a practical sense , portable devices are more expensive than the preparation of the drugs by the patients themselves . However , when comparing with in-hospital treatment the direct costs for a hospital stay exceed that of the devices . Another part of the study evaluated the quality of life using a modified form of SEIQoL-DW ( Schedule for the Evaluation of Individual Quality of Life - Direct Weighting ) . Twenty patients took part in the study and the overall quality of life scores increased significantly when patients received infusion devices compared to reconstituting the drugs themselves Methods for combining data from several studies exist and appear to be quite useful . None satisfactorily addresses the question of what studies should be combined . This issue is the most serious method ological limitation . Even studies with statistically significant interaction might still be combined if the effect were in the same direction . Thus , substantial scientific input is required as to what criteria must be met by each potential study . Much can be learned from combining or pooling data but it must be done cautiously . Pooling exercises do not replace well design ed prospect i ve clinical trials . Efforts for establishing basic design criteria to allow for multicentre and multicountry trials to be more easily combined might be useful . OBJECTIVE Despite widespread adoption of home care services , few r and omised trials have compared health outcomes in the hospital and at home . We report a prospect i ve , r and omised trial of home versus hospital therapy in adults receiving intravenous ( IV ) antibiotics .  Our objective was to show that home care is a feasible alternative to hospitalisation over a broad range of infections , without compromise to quality of life ( QOL ) or clinical outcomes . METHODS Consenting adults requiring IV antibiotics  were r and omised to complete therapy at home or in hospital . Short Form 36 and Perceived Health Competence Scale ( PHCS ) were used for assessment of QOL . Statistical analysis used unpaired t-tests , Mann-Whitney tests and ANOVA . RESULTS One hundred and twenty-nine admissions were referred . Recruitment was hampered by patient preference for one therapy over another . 82 ( 62 % ) were included and r and omised : 44 to home , 38 to hospital ; the two groups had comparable characteristics . There were no differences in improvements in QOL and PHCS scores between the two groups after treatment . Treatment duration was median 11.5 days ( range 3 - 57 ) and 11 days ( range 4 - 126 ) for home and hospital groups , respectively . Home therapy costs , approximately , half that of hospital therapy . Time to readmission was longer after hospital therapy . CONCLUSION Out study showed that home IV therapy is well tolerated , is less costly , is not associated with any major disadvantage to QOL or clinical outcomes compared to hospital therapy , and is an appropriate treatment option for selected patients A controlled prospect i ve study was undertaken to compare the efficacy and benefits of home and hospital treatment for patients with exacerbations of pulmonary disease caused by cystic fibrosis . A total of 41 home and 41 hospital treatments  were analyzed . Home and hospital patients were matched according to sex , age , pulmonary function tests , and arterial blood gas values . Both home and hospital treatments result ed in statistically significant improvement in pulmonary function . A comparison of these values did not show any statistically significant difference between groups at admission or discharge . Furthermore , the mean number of treatment days for both groups , individually determined by the primary physician , was equivalent ( home 17.7 + /- 1.1 days , hospital 18.1 + /- 4.1 ) . The mean charge for a home treatment was approximately $ 10,000 , and for a hospital treatment $ 18,000 . Sixty-five percent of home care patients and 68 % of hospital patients required retreatment for pulmonary exacerbations within the study period ; the interval between pulmonary exacerbations for the two groups was not significantly different . In addition , 85 % of patients receiving treatment at home were able to maintain at least some of their school or work activities . These data indicate that home therapy for cystic fibrosis patients with pulmonary exacerbations is less costly and is as effective as in-hospital therapy 
    Output:
    
Home participants underwent fewer investigations than hospital participants ( P < 0.002 ) and general activity was higher in the home group .
No significant differences were found for clinical outcomes , adverse events , complications or change of intravenous lines , or time to next admission .
Home participants received less  low-dose home maintenance antibiotic .
Quality of life measures showed no significant differences for dyspnoea and emotional state , but fatigue and mastery were worse for home participants , possibly due to a higher general activity and need of support .
Personal , family , sleeping and eating disruptions were less important for home than hospital admissions .
Home therapy was cheaper for families and the hospital .
It suggests that , in the short term , home therapy does not harm individuals , entails fewer investigations , reduces social disruptions and can be cost-effective .
There were both advantages and disadvantages in terms of quality of life .