Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Jonathan Volk

Jonathan Volk, MD

Infectious Diseases

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

San Francisco Medical Center
Appt/Advice: 415-833-2200

See all office information »

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Antibiotics are medicines used to treat bacterial infections. Some serious infections can’t be treated by antibiotics in pill form. Instead, you or your child may need intravenous (IV) antibiotics, delivered through a thin tube into a vein.

IV antibiotics are usually given while you’re in the hospital. Sometimes, you or your child might take them at home or another location away from the hospital. This is called OPAT (outpatient parenteral anti-infective therapy).

OPAT may allow you to go back to work, or your child to attend school.

We’ll talk about treatment together. We’ll also teach you how to:

  • Deliver the antibiotics.
  • Keep the tube clean.


First, we diagnose your infection. We may use blood tests, X-rays, scans, and other tests to:

  • Identify the germ (usually a bacteria).
  • Locate the site of the infection.
  • Identify any existing complications.

We may perform a procedure to remove an infection. We do this if we think the infection might not respond well to antibiotics.

Once we gather this information:

  • We’ll prescribe the best antibiotics to treat you or your child.
  • We may repeat certain tests to check how well treatment is working and decide when to finish treatment.

Treatment Considerations

Before prescribing OPAT, we consider:

  • Infection type.
  • Options for managing the infection.
  • Your family’s personal situation.
  • Whether OPAT is safe and effective for you or your child.
  • Whether you need hospital care.

OPAT is used to treat many types of infections, such as in the heart valve, liver, and bone.

Before prescribing OPAT, we must first:

  • Review your current health and medical history.
  • Diagnose the infection.
  • Check to make sure you’re responding well to treatment.

We must confirm that:

  • The infection or treatment is unlikely to cause serious complications at home.
  • The IV antibiotics can be given safely at home.
  • An IV tube can be successfully placed.

We’ll also make sure that you know how to properly deliver the IV antibiotics.

Remember that we’re available to you for teaching, resources, and follow-up care.

IV Antibiotics

OPAT IV antibiotics are safe, effective, and easy to use at home.

To deliver the antibiotics, we often use a PICC line (peripherally inserted central catheter).

  • A small tube is placed in a vein in the arm.
  • The tube stays in place until you or your child complete treatment.

Only a few pharmacies can provide the medicine and supplies needed for this treatment. Medicine and supplies can be delivered to your home or to a nearby medical clinic.

IV antibiotics are usually given 1 or 2 times a day.

If you need 4 or more daily doses, we may prescribe a small battery-operated portable IV pump. This pump can hold a 24-hour supply of medicine.

IV Care at Home

Before you leave the hospital, nurses will train you (and other family members and caregivers, at your request) to:

  • Flush out the catheter.
  • Properly give the antibiotics.
  • Prevent IV line infection.

During this training, be sure you understand:

  • When and how to deliver daily IV antibiotics. We may schedule doses based on your daily activities.
  • How to avoid infection. Wash your hands with soap and warm water or an alcohol-based solution before touching the IV line. Make sure others do the same.
  • How to protect the IV line. Make sure the line stays in place and stays clean.

A nurse will visit you at home each week to:

  • Check the IV site.
  • Apply a new dressing.
  • Take blood tests.
  • Give you home care, as needed.

Complete your treatment as prescribed. We’ll remove the IV line within a few days after treatment stops. Removal is simple and not painful.

Lifestyle Changes

You or your child can return to daily activities when ready.

Follow these care tips until your treatment is completed and the IV line is removed:

  • Avoid activities that involve sweat, dirt, and water.
  • Don’t tug or rub the IV line area.
  • Follow bathing and showering instructions.
  • Don’t put the arm with the PICC line under water, even if it’s wrapped.

When to Call Us

Contact us if you have any questions while receiving IV antibiotic treatment outside the hospital.

Contact us immediately if you or your child have signs of infection. Infection can cause fever and chills. It can also cause changes around the site where the tube is inserted, such as:

  • Red streaks on the skin
  • Swollen, warm skin
  • Pain or tenderness
  • Fluid draining at the tube site

Your Care with Me

If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.

If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.

During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options and develop a treatment plan that is right for you.

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

For general medical advice, our Appointment and Advice line is available 24 hours per day, 7 days per week.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line. You will be connected with a nurse who can give you immediate advice.

If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:

  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to another specialty colleague

If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.

If surgery or a procedure is a treatment option

I will recommend that you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.

If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.

Convenient Resources for You

As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions.
  • View your past visits and test results.
  • View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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