Outpatient parenteral antimicrobial therapy (OPAT) in a teaching hospital-based practice: a retrospective cohort study describing experience and evolution over 10 years

Barr, David; Semple, L.; Seaton, R.A.

doi:10.1016/j.ijantimicag.2012.01.016

Cited by 115 publications

(114 citation statements)

References 24 publications

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“…22 In particular, Gram-negative infections and extended spectrum beta-lactamase (ESBL) infections are increasingly managed via OPAT. 1 These are usually in the context of a urinary tract infection (UTI) 23 that is not amenable to oral therapy and reflect epidemiological change in the hospital population.…”

Section: Other Infectionsmentioning

confidence: 99%

“…For example, Clostridium difficile-associated disease (CDAD) is rare in OPAT patients, with rates of less than 0.5% per OPAT patient episode in UK cohorts reporting on CDAD. [1][2][3][4] Overall rates of unplanned readmission from OPAT range from 6% to 12%. [1][2][3][4] Appropriate and well supported self-administration of OPAT by patients or carers at home has not been associated with increased rates of complications.…”

Section: Complications Of Opatmentioning

confidence: 99%

“…By minimising hospital stay, OPAT is increasingly recognised as a cost-efficient and acceptable management strategy for a variety of selected patients requiring either short-or medium-to long-term parenteral therapy in the UK (Table 1). [1][2][3][4][5] This short article outlines good practice recommendations and highlights OPAT management of infections commonly encountered by physicians with acute medical duties.…”

Section: Introductionmentioning

confidence: 99%

“…1 Any clinician who has cared for a patient with severe sepsis due to a multi-drug resistant (MDR) Klebsiella pneumoniae will recognise the significance of this misconception. Bacteraemias due to MDR bacteria are estimated to have caused more than 8,000 deaths and excess costs of €62 million in Europe in 2007, and prevailing trends indicate that infections caused by MDR Gram-negative bacteria are rapidly increasing, including in the UK.…”

Section: Introductionmentioning

confidence: 99%

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Outpatient parenteral antimicrobial therapy (OPAT) and the general physician

Barr

Seaton

2013

Clinical Medicine

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Section: Other Infectionsmentioning

confidence: 99%

Section: Complications Of Opatmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outpatient parenteral antimicrobial therapy (OPAT) and the general physician

Barr

Seaton

2013

Clinical Medicine

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“…Outpatient parenteral antimicrobial therapy (OPAT) is frequently used to facilitate early discharge from hospitals, and subsequently to reduce the risk of health care associated infections and to increase patient satisfaction [1]. In the recent years, the use of OPAT services has increased in various countries due to evidence that supports its clinical justification and cost effectiveness [2].…”

Section: Introductionmentioning

confidence: 99%

Outpatient Parenteral Antimicrobial Therapy (OPAT) in the Kingdom of Bahrain: Efficacy, Patient Satisfaction and Cost Effectiveness

Ansari¹

2013

TOIDJ

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Outpatient parenteral antimicrobial therapy (OPAT) is an alternative method to deliver intravenous antimicrobial agents to patients requiring parenteral therapy without an overnight hospital stay. The aim of this study was to review the OPAT services, to explore patient satisfaction with the services provided, and to determine cost effectiveness. A retrospective review for the raw data collected in the OPAT clinic between February 2012 and January 2013 was included. Patients' variables including age, sex, type of infection, and service costs were analyzed with descriptive statistics. Each patient's eligibility was assessed by an infectious disease physician (ID), and a family physician. Patient's satisfaction was measured by a modified short version patient satisfaction questionnaire. Cost was calculated for each patient in the OPAT clinic and compared to the actual cost if the same patient was admitted and treated in the hospital. During the last 12 months, 101 patients, 92 adults, and nine children were treated in our OPAT clinic. Half (50%) of the patients were referred from general practitioner services and our emergency department. Ceftriaxone was the most frequently used antibiotic, prescribed to 76% of the patients. Successful cure was achieved in 97 treated patients. Patients were highly satisfied with the OPAT service with the mean rating of 4.41 SD + 0.31. Cost was reduced from $75, 000 to $30, 000 over one year. This retrospective study suggested that OPAT service is safe and potentially a cost saving approach for the health care system. OPAT service is acceptable and well tolerated among patients receiving intravenous antimicrobial agents.

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More Frequent Premature Antibiotic Discontinuations and Acute Kidney Injury in the Outpatient Setting With Vancomycin Compared to Daptomycin

Tuerff

Núñez

2019

The Journal of Clinical Pharma

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Vancomycin and daptomycin are often used in outpatient parenteral antimicrobial therapy for gram-positive coverage. Vancomycin's narrow therapeutic window poses challenges. We retrospectively assessed acute kidney injury (AKI) and other adverse drug events in outpatient parenteral antimicrobial therapy patients receiving vancomycin or daptomycin at home after hospital discharge. Among 191 patients included, AKI was the most common adverse drug event. Early antibiotic discontinuation and AKI were more frequent in the vancomycin group. Vancomycin use (odds ratio [OR], 4.57; 95% confidence interval [CI], 1.02-20.51); p = 0.04], female sex (OR, 3.28; 95%CI, 1.41-7.67; P < .01), and longer hospitalization (OR, 1.06; 95%CI, 1.01-1.11; P = .02] independently predicted moderate-to-severe AKI. In the vancomycin group, trough concentrations increased after discharge, and were higher in female compared to male patients, and in those who developed moderate-to-severe AKI compared to those who did not. Female sex (OR, 8.37; 95%CI,; P < .01) and higher concentrations (OR, 1.12; 95%CI, 1.05-1.19; P < .01) predicted moderate-to-severe AKI in patients receiving vancomycin. In conclusion, premature antibiotic discontinuations and nephrotoxicity are more frequent in patients treated at home with vancomycin compared to daptomycin. Among patients receiving vancomycin, plasma concentrations increased after hospital discharge and predicted moderate-to-severe AKI. Women had higher vancomycin concentrations and higher risk for AKI.

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Outpatient parenteral antimicrobial therapy (OPAT) in a teaching hospital-based practice: a retrospective cohort study describing experience and evolution over 10 years

Cited by 115 publications

References 24 publications

Outpatient parenteral antimicrobial therapy (OPAT) and the general physician

Outpatient parenteral antimicrobial therapy (OPAT) and the general physician

Outpatient Parenteral Antimicrobial Therapy (OPAT) in the Kingdom of Bahrain: Efficacy, Patient Satisfaction and Cost Effectiveness

More Frequent Premature Antibiotic Discontinuations and Acute Kidney Injury in the Outpatient Setting With Vancomycin Compared to Daptomycin

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Outpatient parenteral antimicrobial therapy (OPAT) in a teaching hospital-based practice: a retrospective cohort study describing experience and evolution over 10 years

Cited by 115 publications

References 24 publications

Outpatient parenteral ­antimicrobial therapy (OPAT) and the general ­physician

Outpatient parenteral ­antimicrobial therapy (OPAT) and the general ­physician

Outpatient Parenteral Antimicrobial Therapy (OPAT) in the Kingdom of Bahrain: Efficacy, Patient Satisfaction and Cost Effectiveness

More Frequent Premature Antibiotic Discontinuations and Acute Kidney Injury in the Outpatient Setting With Vancomycin Compared to Daptomycin

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Product

Resources

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Outpatient parenteral antimicrobial therapy (OPAT) and the general physician

Outpatient parenteral antimicrobial therapy (OPAT) and the general physician