PMID- 30462237
OWN - NLM
STAT- MEDLINE
DCOM- 20200603
LR  - 20210109
IS  - 1460-2091 (Electronic)
IS  - 0305-7453 (Print)
IS  - 0305-7453 (Linking)
VI  - 74
IP  - 3
DP  - 2019 Mar 1
TI  - Intravenous catheter-related adverse events exceed drug-related adverse events in 
      outpatient parenteral antimicrobial therapy.
PG  - 787-790
LID - 10.1093/jac/dky474 [doi]
AB  - BACKGROUND: Drug-related adverse events (AEs) are reported to be common amongst 
      patients receiving outpatient parenteral antimicrobial therapy (OPAT). However, 
      comparative data regarding intravenous (iv) catheter-related AEs are lacking. 
      OBJECTIVES: To compare drug- and iv catheter-related AEs from a large UK OPAT 
      centre. PATIENTS AND METHODS: We reviewed 544 OPAT episodes [median (IQR) age: 57 
      (39-71) years, 60% male, 13% with diabetes] with a median (IQR) duration of 7 
      (2-18) days. Clinically significant drug- and iv catheter-related AEs were 
      calculated as a percentage of OPAT episodes with an AE and also as AEs per 
      1000 iv drug/catheter days. RESULTS: Drug-related AEs complicated 13 (2.4%) OPAT 
      episodes at 1.7 (95% CI 0.9-2.9) per 1000 drug days. Catheter-related AEs 
      occurred more frequently, complicating 32 (5.9%) episodes at 5.7 (95% CI 4.2-7.9) 
      per 1000 iv catheter days (chi2 test for difference in AE rate: P < 0.001). 
      Non-radiologically guided midline catheters were associated with the most 
      frequent AEs (n = 23) at 15.6 (95% CI 10.3-23.4) per 1000 iv catheter days 
      compared with other types of iv catheters (HR 8.4, 95% CI 2.4-51.9, P < 0.004), 
      and self-administration was associated with a higher rate of catheter-related AEs 
      at 12.0 (95% CI 6.0-23.9) per 1000 iv catheter days (HR 4.15, 95% CI 1.7-9.1, 
      P = 0.007). CONCLUSIONS: Clinically significant iv catheter-related AEs occurred 
      more frequently than drug-related AEs, especially when using non-radiologically 
      guided midline catheters. Regular review of the need for iv therapy and switching 
      to oral antimicrobials when appropriate is likely to minimize OPAT-related AEs.
CI  - (c) The Author(s) 2018. Published by Oxford University Press on behalf of the 
      British Society for Antimicrobial Chemotherapy.
FAU - Underwood, Jonathan
AU  - Underwood J
AD  - The Hospital for Tropical Diseases, Division of Infection, University College 
      London Hospitals NHS Foundation Trust, London, UK.
FAU - Marks, Michael
AU  - Marks M
AD  - The Hospital for Tropical Diseases, Division of Infection, University College 
      London Hospitals NHS Foundation Trust, London, UK.
AD  - Clinical Research Department, London School of Hygiene and Tropical Medicine, 
      London, UK.
FAU - Collins, Steve
AU  - Collins S
AD  - The Hospital for Tropical Diseases, Division of Infection, University College 
      London Hospitals NHS Foundation Trust, London, UK.
FAU - Logan, Sarah
AU  - Logan S
AD  - The Hospital for Tropical Diseases, Division of Infection, University College 
      London Hospitals NHS Foundation Trust, London, UK.
FAU - Pollara, Gabriele
AU  - Pollara G
AD  - The Hospital for Tropical Diseases, Division of Infection, University College 
      London Hospitals NHS Foundation Trust, London, UK.
AD  - Division of Infection & Immunity, University College London, London, UK.
LA  - eng
GR  - WT_/Wellcome Trust/United Kingdom
GR  - WT102807/WT_/Wellcome Trust/United Kingdom
GR  - WT101766/WT_/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Antimicrob Chemother
JT  - The Journal of antimicrobial chemotherapy
JID - 7513617
RN  - 0 (Anti-Infective Agents)
SB  - IM
MH  - Administration, Intravenous/adverse effects
MH  - Adult
MH  - Aged
MH  - Anti-Infective Agents/administration & dosage/*adverse effects
MH  - Catheters/*adverse effects/*statistics & numerical data
MH  - Drug-Related Side Effects and Adverse Reactions/*epidemiology/etiology
MH  - Female
MH  - Health Care Surveys
MH  - Humans
MH  - Infusions, Intravenous/adverse effects
MH  - Infusions, Parenteral/*adverse effects/methods/*statistics & numerical data
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - *Outpatients
MH  - Vascular Access Devices/adverse effects/statistics & numerical data
PMC - PMC6376853
EDAT- 2018/11/22 06:00
MHDA- 2020/06/04 06:00
PMCR- 2018/11/20
CRDT- 2018/11/22 06:00
PHST- 2018/08/04 00:00 [received]
PHST- 2018/10/09 00:00 [revised]
PHST- 2018/10/16 00:00 [accepted]
PHST- 2018/11/22 06:00 [pubmed]
PHST- 2020/06/04 06:00 [medline]
PHST- 2018/11/22 06:00 [entrez]
PHST- 2018/11/20 00:00 [pmc-release]
AID - 5193697 [pii]
AID - dky474 [pii]
AID - 10.1093/jac/dky474 [doi]
PST - ppublish
SO  - J Antimicrob Chemother. 2019 Mar 1;74(3):787-790. doi: 10.1093/jac/dky474.