Methods: We conducted a clinical series study of adult patients who received OET during 2014, the first year of OPAT establishment in our center. The main outcomes were cure, 30-day mortality, drug adverse effects and complications. For cost analysis, 20 control patients discharged during 2013 with pyelonephritis were randomly selected to compare the cost of inhospital therapy against the cost of the OET in 20 patients with pyelonephritis.
Results: Among 99 patients who received OET during 2014, the most common comorbid condition was diabetes mellitus (39%). Urinary tract infections (UTI) accounted for 56% of episodes. Regarding microbiologic data, 52 urine cultures and 55 blood cultures were obtained, of which 61% and 34% respectively, had growth of ESBL-producing E. coli.
The mean total duration of OET was 15 days. Ninety-eight patients were cured and one patient died from bacteremia secondary to soft tissue infection. Complications during OET were phlebitis in two patients and one case of diarrhea in which Clostridium difficileinfection was discarded. Three patients were readmitted: one for treatment of phlebitis and two more for symptom control. None of the patients had adverse events leading to discontinuation of ertapenem.
In patients with pyelonephritis that received OET, the cost of the total treatment (ie, inhospital plus outpatient therapy) decreased an average of $1045 US dollars as compared to the cost of inhospital care for control patients. The total number of bed days saved was 857.
Conclusion: OET is effective and safe, with a high cure rate and few complications at HGDMGG. It is also cost-saving when compared to inpatient care.
A. Ortiz Alvarez,
M. A. Delgado Ramirez, None
D. Aguilar-Zapata, None
R. Valdez-Vazquez, None
M. Cuevas, None
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