A Comparison of Outpatient Parenteral (OP) Antibiotic Therapy (AT) Outcomes: Physician Office and Home Based Therapy
The use of OPAT has become a standard modality for patients requiring long term intravenous antibiotics. The delivery of OPAT can be at home or at an OP infusion center (IC). We reviewed outcomes in patients receiving OPAT at one IC (The PIIC Center) and at home.
A database reviewing outcomes for patients (N=117 IC, N=48 home) cared for by the authors in these settings was created with variables reviewed including: demographics, comorbidities, diagnosis, antimicrobials used and duration, type of access, referral site, adverse events, and outcomes. Success was defined as lack of relapse, emergency room (ER) visit, or readmission during OPAT and within 30 days of OPAT discharge. Modified success was defined as resolution of the original infection but with the development of another related infection (e.g. C. difficile or peripheral inserted catheter (PICC) infection) or a line complication (e.g. PICC thrombosis) not requiring ER visits or readmission.
The baseline characteristics in both groups were similar with patients having 6.8 comorbidities per person. The most common diagnoses indicating use of OPAT were: skin, soft tissue, bone and joint, abscess, and urinary tract infections. Patients receiving OPAT at home were more likely to receive PICC lines (82% vs 21%) and have a longer duration of treatment (25 days vs 14 days) compared to patients receiving OPAT at the IC. Home OPAT patients often had issues with access (38% versus 8%) and had a 27% failure rate compared to 7% at the IC.
OPAT provided by the office based IC had better outcomes compared with OPAT provided at home.
The PIIC Center : Owner , Salary
D. Trimble, The PIIC Center : Employee, Salary