Self-administered outpatient parenteral antimicrobial therapy: a report of three years experience in the Irish healthcare setting.
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 euros. 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.
Kieran
J
J
Department of Genitourinary Medicine and Infectious Diseases, St. James Hospital, Dublin 8, Ireland. jkieran2@stjames.ie
O'Reilly
A
A
Parker
J
J
Clarke
S
S
Bergin
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000188:drug therapy*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007262:Infusions, Intravenous; D007494:Ireland; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011446:Prospective Studies; D012646:Self Administration / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents
Int J Antimicrob Agents. 2009 Jan;33(1):46-51
18823759
Pharmacoeconomics. 2000 Nov;18(5):451-7
11151398
Am J Med. 1999 Jan;106(1):44-9
10320116
Int J Qual Health Care. 1996 Jun;8(3):243-51
8885188
Int J Antimicrob Agents. 2006 Dec;28(6):545-50
17097856
J Antimicrob Chemother. 2008 Jul;62(1):177-83
18408239
Pharmacotherapy. 2002 Feb;22(2 Pt 2):63S-70S
11837549
N Z Med J. 2004 Aug 20;117(1200):U1020
15475990
Ann Pharmacother. 2002 Dec;36(12):1851-5
12452743
J Infect. 1999 Sep;39(2):129-33
10609530
Am J Med Sci. 2005 Aug;330(2):60-4
16103785
J Infect. 2001 Apr;42(3):173-5
11545547
Clin Infect Dis. 2004 Jun 15;38(12):1651-72
15227610
Clin Microbiol Infect. 2000 Sep;6(9):464-76
11168180
Pediatrics. 1974 Sep;54(3):358-60
4213282
J Antimicrob Chemother. 2007 Aug;60(2):356-62
17566002