title: Safety and effectiveness of outpatient parenteral antimicrobial therapy in older people.
abstract: OBJECTIVE
  We analyse the safety and effectiveness of self-outpatient parenteral antimicrobial therapy (s-OPAT) in older patients.
  
  
  METHODS
  We prospectively evaluated all adults admitted to our home hospitalization unit (HHU) for s-OPAT in the period 2008-12 in whom the bacteria responsible for the infection were identified. We divided patients into three age groups: <65, 65-79 and ≥80 years. s-OPAT was administered by patients or their caregivers using elastomeric infusion devices. Effectiveness was assessed by analysing readmissions to hospital for inadequate control of underlying infection. Safety was assessed by analysing adverse events, catheter-related complications and readmission to hospital for causes unrelated to inadequate control of underlying infection.
  
  
  RESULTS
  During the study period, 420 episodes of s-OPAT were registered in 351 patients: 139 (33.1%) in patients aged <65 years, 182 (43.3%) in those aged 65-79 years and 99 (23.6%) in those aged ≥80 years. Patients aged ≥80 years had a significantly lower Barthel index. The length of stay for s-OPAT and the complete HHU stay were similar in the three groups. Older people had similar changes in antibiotic treatment and hospital readmission rates due to poor control of underlying infection but higher readmission rates due to worsening of underlying diseases than younger adults. Adverse events and catheter-related complications were similar in the three age groups.
  
  
  CONCLUSIONS
  s-OPAT administered by patients or their caregivers using elastomeric devices was safe and effective in the treatment of infections in older people.
authors.affiliation: Home Hospital Unit, Department of Internal Medicine, Sabadell Hospital, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain amujal@tauli.cat.
authors.forename: Abel
authors.initials: A
authors.lastname: Mujal
authors.affiliation: Home Hospital Unit, Department of Internal Medicine, Sabadell Hospital, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Sola
authors.affiliation: Home Hospital Unit, Department of Internal Medicine, Sabadell Hospital, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Hernandez
authors.affiliation: Acute Geriatric Unit, Albada Centre Sociosanitari, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain.
authors.forename: Maria-Antonia
authors.initials: MA
authors.lastname: Villarino
authors.affiliation: Department of Internal Medicine, Sabadell Hospital, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Baylina
authors.affiliation: Department of Internal Medicine, Sabadell Hospital, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Tajan
authors.affiliation: Department of Internal Medicine, Sabadell Hospital, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain.
authors.forename: Joaquim
authors.initials: J
authors.lastname: Oristrell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D001424:Bacterial Infections / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents