title: Outpatient parenteral antimicrobial therapy for surgery patients: A comparison with previous standard of care.
abstract: BACKGROUND
  Current literature reports that outpatient parenteral antimicrobial therapy (OPAT) programs improve cure rates, and reduce length of hospitalization and costs. OPAT programs are still relatively new in Canada.
  
  
  OBJECTIVE
  To evaluate the benefits of an OPAT program initiated at a multispecialty tertiary care facility in Toronto, Ontario, compared with the previous standard of care.
  
  
  METHODS
  The present retrospective observational study was conducted using data from a group of surgical patients who were treated for active infections. Between February 1, 2010 and November 30, 2010, a total of 108 surgical patients were enrolled in the OPAT program. Patients were matched 1:1 with historical controls discharged between January 1, 2001 and January 1, 2010 according to age, sex, type of surgery, infection and comorbidities (Charlson Comorbidity Index). Cure rate, 30-day rehospitalization and length of stay were evaluated as primary end points.
  
  
  RESULTS
  Of 108 eligible OPAT patients, 21 were matched to the control group using the prespecified criteria. For this cohort, the OPAT program was associated with improved cure rates (OPAT 61.7% versus control 57.1%; P>0.10), reduction in rehospitalization rate (14.3% versus 28.6%; P>0.10) and reduced length of stay (10.7 versus 13.9 days, P>0.10) compared with the control group.
  
  
  CONCLUSIONS
  For this cohort of surgery patients, the OPAT program demonstrated a trend toward improved outcomes but did not achieve statistical significance. Due to the lack of statistical power, further evaluation is required to determine the full benefit of OPAT to patients and the health care system.
authors.affiliation: Department of Pharmacy, University Health Network (Princess Margaret Cancer Centre site);
authors.forename: Anjie
authors.initials: A
authors.lastname: Yang
authors.affiliation: Department of Pharmacy, University Health Network (Princess Margaret Cancer Centre site);
authors.forename: Ron
authors.initials: R
authors.lastname: Fung
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University Health Network (Toronto General Hospital site);
authors.forename: James
authors.initials: J
authors.lastname: Brunton
authors.affiliation: Department of Pharmacy, University Health Network (Toronto General Hospital site); ; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario.
authors.forename: Linda
authors.initials: L
authors.lastname: Dresser
keywords: Home parenteral antimicrobial therapy; OPAT; Outpatient parenteral antimicrobial therapy