Outpatient parenteral antibiotic therapy with daptomycin: insights from a patient registry.
OBJECTIVE
To compare and contrast the characteristics and clinical outcomes of patients who have received daptomycin as outpatients and inpatients.


METHODS
The Cubicin Outcomes Registry and Experience (CORE) is a retrospective chart review of patients who have received daptomycin in participating institutions. Patients treated in 2005 were included in this analysis. Demographic characteristics and clinical outcomes (success = cured + improved) were compared among patients who received outpatient parenteral antibiotic therapy (OPAT) and patients who had received inpatient parenteral antibiotic therapy (IPAT).


RESULTS
Of 1172 patients reported by 52 CORE 2005 participating institutions/investigators, 949 (81.0%) patients were evaluable: 539 (56.8%) received OPAT (OPAT patients), and 410 (43.2%) received only IPAT (IPAT patients). Of the 539 OPAT patients, 273 (50.6%) also received some IPAT, usually preceding OPAT therapy. Successful outcomes [no. of successes/(no. of successes + no. of failures)] for OPAT patients vs. IPAT patients were 94.6% and 86.3% respectively (chi-square test, p < 0.001). OPAT patients were younger, had fewer underlying diseases, were clinically stable, and had fewer adverse events than IPAT patients.


CONCLUSIONS
Outpatient parenteral antibiotic therapy use was common (539/949 or 56.8%) among patients in CORE 2005. Clinical outcomes among OPAT patients appeared at least as good as or better than IPAT patients. Better outcomes among OPAT patients were most likely because of patient selection for OPAT. Additional studies should focus on clinical characteristics of patients who would be ideal candidates for daptomycin OPAT.
Martone
W J
WJ
Cubist Pharmaceuticals, Inc., Lexington, MA 02421, USA. william.martone@cubist.com
Lindfield
K C
KC
Katz
D E
DE
D000368:Aged; D000553:Ambulatory Care / Q000592:standards* / Q000706:statistics & numerical data; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001424:Bacterial Infections / Q000188:drug therapy*; D017576:Daptomycin / Q000008:administration & dosage* / Q000009:adverse effects; D004812:Epidemiologic Methods; D005260:Female; D018718:Home Infusion Therapy / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D017576:Daptomycin