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The Outpatient Parenteral Antimicrobial Therapy (OPAT) Experience in a Referral Hospital in South Carolina

Received: 20 September 2020     Accepted: 29 September 2020     Published: 13 October 2020
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Abstract

Several studies have established outpatient parenteral antibiotic therapy (OPAT) as an alternative to prolonged inpatient stays to reduce healthcare expenditure, decrease hospital admission times, and increase patient satisfaction. However, studies have also shown significant adverse events occurring while receiving treatment outpatient. We collected retrospective data through electronic medical record review on all patients discharged on IV antibiotics whose OPAT was managed by the infectious disease specialists at Greenville Health System between 1/1/17 and 6/30/17. There were a total of 336 individual patients discharged on OPAT during the 6 month period. Bacteremia (25.4%), osteomyelitis (14.9%), and diabetic foot infections (12.8%) were the most common indications for OPAT with methicillin-sensitive staphylococcus aureus (MSSA) being the most common organism targeted (22.5%). 11% of patients had a medication change during their treatment course. The most common reasons were nausea/malaise (26%) and acute kidney injury (26%). Our hospital re-admission rate was 8.7%. Statistical analysis of the data indicated that home infusion was significantly more likely to result in re-admission compared to the infusion center (p=0.02). Also receiving antibiotics for osteomyelitis was more likely to result in re-admission compared to other diagnoses (p=0.048). Our data indicates that self-administration of antibiotics at home results in higher re-admission rates compared to administration at infusion centers. Factors that may contribute to this difference such as compliance, co-morbidities, or frequency of nurse assessments warrant further exploration to optimize the safety of OPAT, especially in rural South Carolina.

Published in International Journal of Infectious Diseases and Therapy (Volume 5, Issue 4)
DOI 10.11648/j.ijidt.20200504.12
Page(s) 112-117
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Outpatient Parenteral Antimicrobial Therapy (OPAT), Infusion Center, Rural Home Care, Readmission

References
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[12] Sriskandarajah S, Hobbs J, Roughead E, Ryan M, Reynolds K. Safety and Effectiveness of ‘Hospital in the Home’ and ‘Outpatient Parenteral Antimicrobial Therapy’ in Different Age Groups: A Systematic Review of Observational Studies.” The International Journal of Clinical Practice. 2018.
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  • APA Style

    Julie Coursen, Prerana Roth, Christopher Schrank, John Schrank. (2020). The Outpatient Parenteral Antimicrobial Therapy (OPAT) Experience in a Referral Hospital in South Carolina. International Journal of Infectious Diseases and Therapy, 5(4), 112-117. https://doi.org/10.11648/j.ijidt.20200504.12

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    ACS Style

    Julie Coursen; Prerana Roth; Christopher Schrank; John Schrank. The Outpatient Parenteral Antimicrobial Therapy (OPAT) Experience in a Referral Hospital in South Carolina. Int. J. Infect. Dis. Ther. 2020, 5(4), 112-117. doi: 10.11648/j.ijidt.20200504.12

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    AMA Style

    Julie Coursen, Prerana Roth, Christopher Schrank, John Schrank. The Outpatient Parenteral Antimicrobial Therapy (OPAT) Experience in a Referral Hospital in South Carolina. Int J Infect Dis Ther. 2020;5(4):112-117. doi: 10.11648/j.ijidt.20200504.12

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  • @article{10.11648/j.ijidt.20200504.12,
      author = {Julie Coursen and Prerana Roth and Christopher Schrank and John Schrank},
      title = {The Outpatient Parenteral Antimicrobial Therapy (OPAT) Experience in a Referral Hospital in South Carolina},
      journal = {International Journal of Infectious Diseases and Therapy},
      volume = {5},
      number = {4},
      pages = {112-117},
      doi = {10.11648/j.ijidt.20200504.12},
      url = {https://doi.org/10.11648/j.ijidt.20200504.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20200504.12},
      abstract = {Several studies have established outpatient parenteral antibiotic therapy (OPAT) as an alternative to prolonged inpatient stays to reduce healthcare expenditure, decrease hospital admission times, and increase patient satisfaction. However, studies have also shown significant adverse events occurring while receiving treatment outpatient. We collected retrospective data through electronic medical record review on all patients discharged on IV antibiotics whose OPAT was managed by the infectious disease specialists at Greenville Health System between 1/1/17 and 6/30/17. There were a total of 336 individual patients discharged on OPAT during the 6 month period. Bacteremia (25.4%), osteomyelitis (14.9%), and diabetic foot infections (12.8%) were the most common indications for OPAT with methicillin-sensitive staphylococcus aureus (MSSA) being the most common organism targeted (22.5%). 11% of patients had a medication change during their treatment course. The most common reasons were nausea/malaise (26%) and acute kidney injury (26%). Our hospital re-admission rate was 8.7%. Statistical analysis of the data indicated that home infusion was significantly more likely to result in re-admission compared to the infusion center (p=0.02). Also receiving antibiotics for osteomyelitis was more likely to result in re-admission compared to other diagnoses (p=0.048). Our data indicates that self-administration of antibiotics at home results in higher re-admission rates compared to administration at infusion centers. Factors that may contribute to this difference such as compliance, co-morbidities, or frequency of nurse assessments warrant further exploration to optimize the safety of OPAT, especially in rural South Carolina.},
     year = {2020}
    }
    

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Author Information
  • Department of Medicine, University of South Carolina School of Medicine Greenville, Greenville, USA

  • Department of Medicine, Prisma Health, Greenville, USA

  • Department of Medicine, Prisma Health, Greenville, USA

  • Department of Medicine, Prisma Health, Greenville, USA

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