title: Outpatient parenteral antimicrobial therapy for infective endocarditis: a cost-effective strategy.
abstract: OBJECTIVE
  We evaluated the benefit/risk ratio of outpatient parenteral antimicrobial therapy (OPAT) in infective endocarditis (IE).
  
  
  METHODS
  We performed an observational retrospective study of definite IE (Duke criteria) treated in an infectious diseases unit in 2012. We compared patients having completed the treatment in hospital (H), and those deemed sufficiently stable, and with adequate home environment, for OPAT. The costs were estimated through hospital bills, and, for OPAT, through the costs of drugs and their administration (material, staff), transportation, and outpatient visits.
  
  
  RESULTS
  Eighteen out of 39 consecutive patients presenting with IE received OPAT, with a mean hospital stay of 23.5days (vs 34.7days for H group, P=0.014). No severe adverse event related to OPAT was reported. The global saving was estimated at 267,307euros, or 14,850euros per patient.
  
  
  CONCLUSIONS
  OPAT in selected patients presenting with IE seems effective, safe, and reduces costs by approximately 15,000euros per patient.
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Lacroix
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France; CIC-Inserm 0203, faculté de médecine, université Rennes 1, IFR140, 35000 Rennes, France.
authors.forename: M
authors.initials: M
authors.lastname: Revest
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Patrat-Delon
authors.affiliation: Département de pharmacologie clinique, CHU Pontchaillou, 35033 Rennes cedex, France; CIC-Inserm 0203, faculté de médecine, université Rennes 1, IFR140, 35000 Rennes, France.
authors.forename: F
authors.initials: F
authors.lastname: Lemaître
authors.affiliation: Département de cardiologie et maladies vasculaires, CHU Pontchaillou, 35033 Rennes cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Donal
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Lorléac'h
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Arvieux
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France; CIC-Inserm 0203, faculté de médecine, université Rennes 1, IFR140, 35000 Rennes, France.
authors.forename: C
authors.initials: C
authors.lastname: Michelet
authors.affiliation: Service des maladies infectieuses et réanimation médicale, CHU Pontchaillou, 2, rue Le-Guilloux, 35033 Rennes cedex, France; CIC-Inserm 0203, faculté de médecine, université Rennes 1, IFR140, 35000 Rennes, France; Inserm U835, faculté de médecine, université Rennes 1, IFR140, 35000 Rennes, France. Electronic address: pierre.tattevin@chu-rennes.fr.
authors.forename: P
authors.initials: P
authors.lastname: Tattevin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics*; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000191:economics*; D062905:Central Venous Catheters; D003131:Combined Modality Therapy; D017046:Cost Savings; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D016527:Drug Costs / Q000706:statistics & numerical data; D004696:Endocarditis / Q000188:drug therapy* / Q000191:economics / Q000601:surgery; D005260:Female; D005602:France; D006699:Home Care Services / Q000191:economics* / Q000458:organization & administration; D017721:Hospital Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D015918:Infusion Pumps, Implantable; D007262:Infusions, Intravenous; D007267:Injections; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000191:economics; D011788:Quality of Life; D012189:Retrospective Studies; D014186:Transportation / Q000191:economics; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents
keywords: Antibiothérapie parentérale ambulatoire; Cost-effectiveness; Coût-efficacité; Endocardite infectieuse; Infective endocarditis; Outpatient parenteral antimicrobial therapy