title: [Evaluation of the effectiveness, safety and costs of outpatient intravenous antimicrobial treatment (OPAT) vs hospitalized in urinary infection in pediatrics].
abstract: BACKGROUND
  Childrens hospitalization for intravenous antibiotic treatment has been replaced in developed countries and in some Chilean centers to outpatient intravenous therapy (OPAT).
  
  
  OBJECTIVE
  To compare the effectiveness, safety and cost of OPAT versus inpatient care.
  
  
  METHODS
  Prospective cohort study in children (2 months-5 years) with febrile urinary tract infection (UTI) attended at two public Chilean hospitals: outpatient cohort and inpatient cohort. Between November of 2009-2010, 111 children were enrolled in OPAT and between January 2010-June 2011, 81 children were hospitalized. Demographic data, costs and parental care, response to treatment, adverse events and complications were registered.
  
  
  RESULTS
  There was no difference in the effectiveness of both treatments (100% in OPAT and 98.6% in inpatient cohort, p: 0.41). Adherence to OPAT was 100%. Prevalence of adverse events was higher in inpatient cohort (76.3% versus 16.2%, p < 0.01). The average direct cost was four times higher in inpatients, mainly due to bed-day cost. Indirect cost was similar in both groups. There were more days of absence from work and care centers in inpatients (p: 0.017, p: 0.045 respectively).
  
  
  CONCLUSIONS
  OPAT for febrile UTI was equally effective, safer and significantly less expensive than inpatient care. OPAT represents a recommended intervention for pediatric services of Chilean public hospitals.
authors.affiliation: Departamento de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: Anamaría
authors.initials: A
authors.lastname: Peña
authors.forename: Alexsandra
authors.initials: A
authors.lastname: Zambrano
authors.forename: Muriel
authors.initials: M
authors.lastname: Alvarado
authors.forename: Jaime
authors.initials: J
authors.lastname: Cerda
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Vergara
mesh_terms: D000553:Ambulatory Care / Q000191:economics* / Q000706:statistics & numerical data; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D002675:Child, Preschool; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D014552:Urinary Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents