Treatment of lower respiratory tract infections in Italy: the role of outpatient parenteral antibiotic therapy.
The use of outpatient parenteral antibiotic therapy (OPAT) has enjoyed substantial success in Italy, where patients generally believe that treatment at home is better than in the hospital. Intramuscular administration, which is commonplace in Italy, facilitates OPAT, requiring minimal training and circumventing intravenous access problems. The Italian OPAT model is a general practice-based model, but a team approach is used in the presence of severe disease, such as HIV. Seven centers in Italy are participating in the International OPAT Outcomes Registry, and have enrolled about 200 patients over 8 months. Eighty patients (40%) were treated for lower respiratory tract infections (60 pneumonia, 20 bronchitis). Most pneumonia patients had concomitant disease, including chronic heart disease, HIV and cancer. The most frequently used therapy was ceftriaxone, which permits once-daily convenience due to its prolonged half-life. Antibiotics were administered intramuscularly in more than 50% of cases. Clinical outcome was excellent, and patient and physician satisfaction was high.
Esposito
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Clinica Malattie Infettive, Seconda Università degli Studi di Napoli, Naples, Italy. Silvanoesposito@libero.it
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006801:Humans; D007263:Infusions, Parenteral; D007273:Injections, Intramuscular; D007558:Italy; D010045:Outpatients; D011014:Pneumonia / Q000188:drug therapy / Q000473:pathology; D012042:Registries; D012141:Respiratory Tract Infections / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies
D000900:Anti-Bacterial Agents