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Self-administered outpatient parenteral antimicrobial therapy: a report of three years experience in the Irish healthcare setting

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Abstract

Outpatient parenteral antibiotic therapy (OPAT) was first reported in 1972. OPAT programmes are not well established in Ireland, with no reported outcomes in the literature. An OPAT programme was established at St. James Hospital in 2006. Demographics, diagnoses and outcomes of the first 60 courses are reported. A retrospective analysis of prospectively recorded data was performed on patients treated from March 2006 to February 2009. The data was analysed using SPSS v.17. Sixty OPAT courses were administered to 56 patients, 57 percent of which were male. The median age was 50 years, the median inpatient stay was 19 days, the median duration of OPAT was 16 days and 1,289 inpatient bed days were saved. The additional cost per day of OPAT was €167.60. Vancomycin was the most prescribed antimicrobial, administered to 35%. Musculoskeletal infection was the indication for treatment in 50%. Confirmatory microbiological diagnosis was identified in 72%, most frequently due to Staphylococcus aureus (68%). Only minor adverse events were recorded. Clinical cure was achieved in 92.8%. A patient satisfaction survey showed high satisfaction. OPAT is a safe and effective way of providing parenteral antibiotic therapy in the Irish healthcare system. Better integration of funding and the appointment of Infectious Diseases specialists will facilitate its expansion.

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References

  1. Rucker RW, Harrison GM (1974) Outpatient intravenous medications in the management of cystic fibrosis. Pediatrics 54(3):358–360

    CAS  PubMed  Google Scholar 

  2. Wai AO, Frighetto L, Marra CA, Chan E, Jewesson PJ (2000) Cost analysis of an adult outpatient parenteral antibiotic therapy (OPAT) programme. A Canadian teaching hospital and Ministry of Health perspective. Pharmacoeconomics 18(5):451–457. doi:10.2165/00019053-200018050-00004

    Article  CAS  PubMed  Google Scholar 

  3. Tice AD (1996) Outpatient and parenteral antibiotic therapy in different countries. Int J Infect Dis 1:102–106. doi:10.1016/S1201-9712(96)90063-6

    Article  Google Scholar 

  4. Seaton RA, Nathwani D, Williams FL, Boyter AC (1999) Feasibility of an outpatient and home parenteral antibiotic therapy (OHPAT) programme in Tayside, Scotland. J Infect 39(2):129–133. doi:10.1016/S0163-4453(99)90004-X

    Article  CAS  PubMed  Google Scholar 

  5. Yong C, Fisher DA, Sklar GE, Li SC (2009) A cost analysis of Outpatient Parenteral Antibiotic Therapy (OPAT): an Asian perspective. Int J Antimicrob Agents 33(1):46–51. doi:10.1016/j.ijantimicag.2008.07.016

    Article  CAS  PubMed  Google Scholar 

  6. Fisher DA, Kurup A, Lye D, Tambyah PA, Sulaiman Z, Poon EY et al (2006) Outpatient parenteral antibiotic therapy in Singapore. Int J Antimicrob Agents 28(6):545–550. doi:10.1016/j.ijantimicag.2006.08.018

    Article  CAS  PubMed  Google Scholar 

  7. Matthews PC, Conlon CP, Berendt AR, Kayley J, Jefferies L, Atkins BL, Byren I (2007) Outpatient parenteral antimicrobial therapy (OPAT): is it safe for selected patients to self-administer at home? A retrospective analysis of a large cohort over 13 years. J Antimicrob Chemother 60(2):356–362. doi:10.1093/jac/dkm210

    Article  CAS  PubMed  Google Scholar 

  8. Goodfellow AF, Wai AO, Frighetto L, Marra CA, Ferreira BM, Chase ML et al (2002) Quality-of-life assessment in an outpatient parenteral antibiotic program. Ann Pharmacother 36(12):1851–1855. doi:10.1345/aph.1C153

    Article  PubMed  Google Scholar 

  9. Montalto M (1996) Patients’ and carers’ satisfaction with hospital-in-the-home care. Int J Qual Health Care 8(3):243–251. doi:10.1016/1353-4505(96)00029-4

    Article  CAS  PubMed  Google Scholar 

  10. Nathwani D, Morrison J (2001) Parenteral therapy in the outpatient or home setting: evidence, evaluation and future prospects. J Infect 42(3):173–175. doi:10.1053/jinf.2001.0823

    Article  CAS  PubMed  Google Scholar 

  11. O’Reilly A (2005) Personal correspondence. Department of Pharmacy, St. James Hospital, Dublin, Ireland

  12. Nathwani D, Zambrowski JJ, AdHOC Workshop (2000) Advisory group on Home-based and Outpatient Care (AdHOC): an international consensus statement on non-inpatient parenteral therapy. Clin Microbiol Infect 6:464–476

    Article  CAS  PubMed  Google Scholar 

  13. Tice AD, Rehm SJ, Dalovisio JR, Bradley JS, Martinelli LP, Graham DR et al (2004) Practice guidelines for outpatient parenteral antimicrobial therapy. IDSA guidelines. Clin Infect Dis 38(12):1651–1672. doi:10.1086/420939

    Article  PubMed  Google Scholar 

  14. Upton A, Ellis-Pegler RB, Woodhouse A (2004) Outpatient Parenteral Antimicrobial Therapy (OPAT): a review of experience at Auckland Hospital. N Z Med J 117(1200):U1020

    PubMed  Google Scholar 

  15. Tice AD, Hoaglund PA, Nolet B, McKinnon PS, Mozaffari E (2002) Cost perspectives for outpatient intravenous antimicrobial therapy. Pharmacotherapy 22(2 Pt 2):63S–70S. doi:10.1592/phco.22.4.63S.33653

    Article  PubMed  Google Scholar 

  16. Gilchrist M, Franklin BD, Patel JP (2008) An outpatient parenteral antibiotic therapy (OPAT) map to identify risks associated with an OPAT service. J Antimicrob Chemother 62(1):177–183. doi:10.1093/jac/dkn152

    Article  CAS  PubMed  Google Scholar 

  17. Hoffman-Terry ML, Fraimow HS, Fox TR, Swift BG, Wolf JE (1999) Adverse effects of outpatient parenteral antibiotic therapy. Am J Med 106(1):44–49. doi:10.1016/S0002-9343(98)00362-3

    Article  CAS  PubMed  Google Scholar 

  18. Sharma R, Loomis W, Brown RB (2005) Impact of mandatory inpatient infectious disease consultation on outpatient parenteral antibiotic therapy. Am J Med Sci 330(2):60–64. doi:10.1097/00000441-200508000-00002

    Article  PubMed  Google Scholar 

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Kieran, J., O’Reilly, A., Parker, J. et al. Self-administered outpatient parenteral antimicrobial therapy: a report of three years experience in the Irish healthcare setting. Eur J Clin Microbiol Infect Dis 28, 1369–1374 (2009). https://doi.org/10.1007/s10096-009-0794-5

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  • DOI: https://doi.org/10.1007/s10096-009-0794-5

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