Program Schedule

Effectiveness, Safety, and Impact on Healthcare Decongestion by a Busy Canadian Infusion Centre for Outpatient Parenteral Antimicrobial Therapy

Session: Poster Abstract Session: Clinical Practice Issues
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
  • IDWeek Poster - v4.0 FINAL.pdf (678.5 kB)
  • Background: Outpatient Parenteral Antimicrobial Therapy (OPAT) provides intravenous (IV) antibiotic therapy to patients in an ambulatory setting. Typically OPAT is overseen by Emergency Room (ER) physicians. However, in 2011 a stand-alone infusion center was created to decongest the Surrey Memorial Hospital ER, the second busiest in Canada. The infusion centre is staffed by infectious diseases (ID) specialists who oversee care with a multidisciplinary care team. This study describes and evaluates the infusion center with respect to safety, efficacy, antibiotic de-escalation, and ability to decongest the ER.

    Methods:   This retrospective observational study evaluated patients treated at the infusion centre between October 1, 2012 and September 30, 2013. Six hundred patients registered in the infusion centre were randomly selected. For subjects meeting inclusion and exclusion criteria, medical records were reviewed for demographics, clinical information, microbiology, antibiotic usage, and outcomes. Treatment success was defined as improvement in referral condition at end of therapy without relapse or hospital admission within 30 days of discharge.

    Results: During the study period, 1900 patients were referred to the infusion centre.  Of the 600 patients, 523 met inclusion and exclusion criteria. The most common sites of infection were skin and soft tissue (44.8%), urinary tract (16.3%), and oral/ear-nose-throat (9.0%). Mean duration of therapy at the infusion centre was 6.1 days; resulting in 3456 patient-days diverted from ER and inpatient beds. In addition, 39.1% of episodes had discontinuation or oral step down of their antibiotic regimen. Of the 503 episodes with outcome data, treatment success was found in 414 episodes (82.3%). Mortality rate was 0.6%. Adverse drug reaction rate was 7.8/1000 OPAT patient-days, with no C. difficile or serious IV line complications.

    Conclusion: The infusion centre model of OPAT is a safe and effective means of delivering IV antibiotics. It has shown significant impact on ER decongestion and potentially reduced unnecessary hospital admissions, which may lead to significant cost savings. In addition, antibiotic stewardship was achieved with early de-escalation of antibiotics.

    Kevin Afra, MD1, Maggie Wong, PharmD2, Michael G. Chapman, MD1,2,3, Yazdan Mirzanejad, MD1,2,3 and Gregory D. Deans, MD, MHSc1,2,3, (1)University of British Columbia, Vancouver, BC, Canada, (2)Jim Pattison Outpatient Care and Surgery Centre, Surrey, BC, Canada, (3)Surrey Memorial Hospital, Surrey, BC, Canada


    K. Afra, None

    M. Wong, None

    M. G. Chapman, None

    Y. Mirzanejad, None

    G. D. Deans, None

    Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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