Methods: A retrospective multi-center (n=20) review was conducted of peds ≤ 18 years (n=64) treated for infection at a POIC from 1-2013 to 12-2014. Data collected included demographics, co-morbidities, cultures, drug regimen, adverse events, emergency department (ED) visits, hospital admissions and clinical outcomes. Clinical success was defined as cure or improvement at end of therapy.
Results: Sixty four peds were admitted to a POIC over 2 years (yrs) for OPAT. Mean age was 16 yrs (range 6 -18), with 61% males (n=39). Co-morbidities were infrequent with 32 peds (50%) having none and 16 (25%) having one. Forty-two peds (66%) had prior hospitalization, whereas 22 peds (34%) had OPAT initiated in the POIC. Most frequent diagnoses included cellulitis with abscess (n=18), osteomyelitis (n=11), complicated intra-abdominal infection (n=9), infectious arthritis (n=6), meningitis (n=5) and postoperative wound infection (n=3). Most common OPAT included cefazolin (n=8), cefepime (n=2), cefotaxime (n=2), ceftriaxone (n=19), daptomycin (n=8), ertapenem (n=9), imipenem/cilastatin (n=5), piperacillin/tazobactam (n=6), and vancomycin (n=10). Seventeen (27%) peds received more than one OPAT in combination or sequentially. Mean duration of therapy was 17 days (range 1-56). Six peds (9%) required ED visits, but only 1 (2%) required catheter removal. Two peds required hospital admission. Adverse events occurred in 21 peds (33%) including diarrhea (n=5), itching (n=4), rash (n=3), neutropenia (n=2), thrombocytopenia (n=1) and drug-induced hepatitis (n=1). Thrombocytopenia, neutropenia, and hepatitis were managed by drug alteration and all patients completed therapy. Clinical success was achieved in 64 peds (100%) with 50 peds (78%) cured and 14 peds (22%) improved.
Conclusion: Based on this 2-year study, use of POIC for the treatment of pediatric infections using various OPAT regimens was a safe and effective option. The incidence of adverse events remained low and treatments were well-tolerated in this population.
R. V. Nathan,
Forest/Actavis: Speaker's Bureau , Speaker honorarium
J. R. Bernett, None
R. C. Prokesch, None
Q. Luu, None
K. Couch, Cubist/Merck: Speaker's Bureau , Speaker honorarium
C. P. Schroeder, None