PMID- 30986525
OWN - NLM
STAT- MEDLINE
DCOM- 20191203
LR  - 20210109
IS  - 1872-7913 (Electronic)
IS  - 0924-8579 (Linking)
VI  - 54
IP  - 2
DP  - 2019 Aug
TI  - Factors associated with successful completion of outpatient parenteral antibiotic 
      therapy (OPAT): A 10-year review from a large West London service.
PG  - 207-214
LID - S0924-8579(19)30094-9 [pii]
LID - 10.1016/j.ijantimicag.2019.04.008 [doi]
AB  - Outpatient parenteral antibiotic therapy (OPAT) is an established antimicrobial 
      delivery method in the UK. OPAT services differ nationwide, with a paucity of 
      high-quality outcome data to enable benchmarking. A retrospective review of 
      clinical outcomes and adverse events (AEs) of all patients treated during 
      2008-2017 was performed to identify factors associated with success and failure. 
      Regression models were used to identify factors associated with OPAT success, and 
      AEs were described for the study population using definitions recommended by 
      BSAC. In the 10-year period, 2870 patient episodes resulted in 69 610 days of 
      treatment, with a 91.7% rate of successful therapy completion and 92.0% of 
      infections cured or improved. We encountered 196 AEs, including 1 case of 
      Clostridium difficile-associated diarrhoea. AEs occurred in 10.9% of patient 
      episodes. Adverse drug and line events occurred at a rate of 3.3 and 1.78 per 
      1000 treatment days, respectively. Rashes, blood dyscrasias and hepatitis were 
      the most common drug AEs. The odds of OPAT success was greater for patients who 
      spent more time (>14 days) on OPAT therapy (OR = 2.32; P < 0.01), utilised a 
      peripheral line (OR = 1.83; P < 0.01), were treated in the clinic compared with 
      self-administration (OR = 2.1; P < 0.02) and did not experience an AE (OR = 0.23; 
      P < 0.01). In our setting, the odds of a successful OPAT episode were associated 
      with longer treatment course, OPAT delivered via a peripheral line, 
      administration in an OPAT clinic setting, and no adverse line or drug events.
CI  - Copyright (c) 2019 Elsevier B.V. and International Society of Chemotherapy. All 
      rights reserved.
FAU - Hatcher, James
AU  - Hatcher J
AD  - Department of Infection, Imperial College Healthcare NHS Trust, Charing Cross 
      Hospital, London W6 8RF, UK.
FAU - Costelloe, Ceire
AU  - Costelloe C
AD  - Department of Primary Care and Public Health, School of Public Health, Imperial 
      College London, London, UK.
FAU - Cele, Richard
AU  - Cele R
AD  - Department of Infection, Imperial College Healthcare NHS Trust, Charing Cross 
      Hospital, London W6 8RF, UK.
FAU - Viljanen, Anu
AU  - Viljanen A
AD  - Department of Infection, Imperial College Healthcare NHS Trust, Charing Cross 
      Hospital, London W6 8RF, UK.
FAU - Samarasinghe, Dunisha
AU  - Samarasinghe D
AD  - Department of Infection, Imperial College Healthcare NHS Trust, Charing Cross 
      Hospital, London W6 8RF, UK.
FAU - Satta, Giovanni
AU  - Satta G
AD  - Department of Infection, Imperial College Healthcare NHS Trust, Charing Cross 
      Hospital, London W6 8RF, UK.
FAU - Brannigan, Eimear
AU  - Brannigan E
AD  - Department of Infection, Imperial College Healthcare NHS Trust, Charing Cross 
      Hospital, London W6 8RF, UK.
FAU - De Barra, Eoghan
AU  - De Barra E
AD  - Department of Infection, Imperial College Healthcare NHS Trust, Charing Cross 
      Hospital, London W6 8RF, UK.
FAU - Sanderson, Frances
AU  - Sanderson F
AD  - Department of Infection, Imperial College Healthcare NHS Trust, Charing Cross 
      Hospital, London W6 8RF, UK.
FAU - Gilchrist, Mark
AU  - Gilchrist M
AD  - Department of Infection, Imperial College Healthcare NHS Trust, Charing Cross 
      Hospital, London W6 8RF, UK. Electronic address: mark.gilchrist1@nhs.net.
LA  - eng
GR  - CDF-2016-09-015/DH_/Department of Health/United Kingdom
PT  - Journal Article
DEP - 20190412
PL  - Netherlands
TA  - Int J Antimicrob Agents
JT  - International journal of antimicrobial agents
JID - 9111860
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Ambulatory Care/*methods
MH  - Anti-Bacterial Agents/*administration & dosage
MH  - Bacterial Infections/*drug therapy
MH  - Drug-Related Side Effects and Adverse Reactions/epidemiology/pathology
MH  - Female
MH  - Health Services Research
MH  - Humans
MH  - London
MH  - Male
MH  - Middle Aged
MH  - *Outpatients
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Adverse events
OT  - Antimicrobial stewardship
OT  - Intravenous antibiotics
OT  - OPAT
EDAT- 2019/04/16 06:00
MHDA- 2019/12/04 06:00
CRDT- 2019/04/16 06:00
PHST- 2018/11/24 00:00 [received]
PHST- 2019/04/02 00:00 [revised]
PHST- 2019/04/09 00:00 [accepted]
PHST- 2019/04/16 06:00 [pubmed]
PHST- 2019/12/04 06:00 [medline]
PHST- 2019/04/16 06:00 [entrez]
AID - S0924-8579(19)30094-9 [pii]
AID - 10.1016/j.ijantimicag.2019.04.008 [doi]
PST - ppublish
SO  - Int J Antimicrob Agents. 2019 Aug;54(2):207-214. doi: 
      10.1016/j.ijantimicag.2019.04.008. Epub 2019 Apr 12.