Effectiveness, Safety, and Impact on Healthcare Decongestion by a Busy Canadian Infusion Centre for Outpatient Parenteral Antimicrobial Therapy
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.
M. G. Chapman, None
Y. Mirzanejad, None
G. D. Deans, None