Outpatient parenteral antibiotic therapy (OPAT) is considered to be a cost-effective and safe alternative treatment strategy to hospitalization. We retrospectively evaluated data regarding the demographic and treatment characteristics of patients that sought medical advice from a network of physicians performing house-call visits and who received OPAT at home during a 17-month period (May 2009 to September 2010) in Attica, Greece. A total of 91 patients (69.2 % females) received intravenous antibiotic therapy at home during the evaluated period. The mean age [± standard deviation (SD)] of the patients was 85.3 (± 9) years. The main indications were pneumonia [46 patients (50.5 %)], urinary tract infection [25 (27.5 %)], and gastrointestinal tract infection [9 (9.9 %)]. Of the patients, 76.4 % received a beta-lactam, 17.5 % a fluoroquinolone, 15.3 % an imidazole, 8.7 % an aminoglycoside, and 5.4 % a lincosamide. The cure rate was 72.5 % and mortality was 27.5 %. The mean duration (± SD) of intravenous antibiotic treatment was 4.7 (± 3.3) days. The mean cost per patient was 637 and was comparable to the mean cost if the patient were to be hospitalized for the same infection. There was significant clinical effectiveness of OPAT at home in this mainly elderly population, at an acceptable cost.

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BackgroundThe SOS-doctors are a network of physicians who perform house-call visits in the areas of Attica and Thessaloniki, Greece.MethodsPatients requesting medical services by the SOS doctors during the period 1/1/2005 – 31/12/2015 were eligible for inclusion in this retrospective analysis.ResultsDuring this period 335, 212 home visits were performed. Females used this service more frequently compared to males (60.5% versus 39.5%). Among the age-groups, patients aged over 75 years made 56.6% of all house calls. Fewer phone requests were recorded during autumn than in winter (21.1% versus 29.1%). Infections were the most common cause of house-visits (29%), followed by cardiovascular diseases (10.3%), musculoskeletal (9.1%), gastrointestinal (6.3%) and neurological disorders (3.7%). An increasing demand for radiology at home was observed, starting at 352 calls in 2009 and reaching 2230 in 2015. Finally, 9.2% of patients were advised to be admitted into a hospital.ConclusionA shift towards older age, but not the oldest old (> 90 years), and acute conditions was observed during the study period. The study confirms that home visits retain a significant role in the modern health care systems.

Over the last decade, travel medicine was mainly focused on the epidemiology of diseases among travelers to developing countries. However, less is known about travel-related morbidity in Europe. We evaluated the demographic and clinical characteristics of foreign travelers to Greece during a 5-year period (01/01/2005 - 31/12/2009) who sought medical services from a network of physicians performing house-call visits (SOS Doctors) in the area of Attica, Greece. Overall, 3,414 foreign travelers [children (≤18 years of age): 27%] were identified; 151 (4.4%) required transfer to a hospital. The most common clinical entities were: respiratory disorders (34%), diarrheal disease (19%), musculoskeletal (12%), dermatologic (7%), non-diarrheal gastrointestinal (6%), and genitourinary (5%) disorders. Respiratory disorders were the most frequent diagnosis during all seasons, followed by diarrheal gastrointestinal and musculoskeletal disorders. Respiratory and dental conditions were observed significantly more frequently in children. Respiratory disorders were observed significantly more frequently during winter (47%) compared to spring (36.7%), summer (30.9%), and autumn (30.5%), (p < 0.01). Despite the limitations of the retrospective methodology, our findings suggest that mild, self-limited respiratory events may be the prevalent cause for seeking primary health care during travel to Greece. Our findings may be extrapolated to other countries with similar climatic and socioeconomic status.

Summary Background:  The latest influenza pandemic intensified the interest in this infection. Objective:  We aimed to compare the characteristics of outpatients with seasonal and pandemic influenza. Methods:  We retrospectively reviewed data regarding outpatients who sought medical advice from a network of physicians performing house‐call visits at the area of Attica, Greece, and who underwent a direct influenza test during the period of seasonal influenza (1/1/2009–1/5/2009) and 2009 H1N1 pandemic influenza period (17/5/2009–15/4/2010). Results:  A total of 195 and 1317 patients had a direct influenza test during the seasonal and pandemic influenza period, respectively; 50.7% and 32% of these patients had a positive test result for influenza, respectively. Viral culture or polymerase chain reaction (PCR) were not implemented. Patients found positive for influenza during the pandemic period, compared with those evaluated during the seasonal period, were younger (mean age ± SD: 33 ± 17.2 vs. 38.2 ± 19.2, p = 0.008), more likely to have no comorbidity (62.9% vs. 45.5%, p = 0.002), had milder clinical manifestations, and were treated with more antibiotics (38.3% vs. 9.9%, p < 0.001). However, patients found positive during the seasonal period were treated with more antivirals (oseltamivir: 69.1% vs. 85.7%, p = 0.006). No difference was observed regarding the need for immediate hospitalisation. These findings were consistent in the complementary analysis involving patients tested for influenza during the compared periods. Conclusion:  Despite the methodological limitations, our findings suggest that patients with pandemic influenza were younger, had milder clinical manifestations and were less likely to have any kind of comorbidity compared with patients with seasonal influenza.