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Acta Clin Belg ; 75(4): 275-283, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31023169

RESUMEN

BACKGROUND: Outpatient parenteral antibiotic therapy (OPAT) was not used in Belgium before 2013, except for patients with cystic fibrosis. Thus, we have performed a pilot study to evaluate clinical characteristics and outcomes of patient receiving OPAT in a Belgian setting. METHODS: The study was a prospective observational single-center study of patients receiving OPAT between 1 September 2013 and 31 December, 2017. RESULTS: We included 218 OPATs. The median age was 58 years and 71% were men. At the end of the treatment, 92% of the patients on OPAT were cured. Risk factors for treatment failure were obesity, diabetes and diabetic foot infections, longer duration of hospitalization before OPAT, and duration of OPAT >16 days. An average of 24 days of hospitalization per patient discharge was saved, which amounted to 5205 days saved during the project. During the OPAT and 30 days thereafter, 71 (32.6%) of patients were readmitted, but only 26 (12%) readmissions were directly related to OPAT. Risk factors for readmissions were diabetes and diabetic foot infections, endovascular infections, longer duration of hospitalization before OPAT, duration of OPAT >30 days, and history of hospitalizations in the year before OPAT. There were 2.3 intravenous catheter-related events per 1000 days of catheter use. Patients' level of satisfaction was high (99.5%). CONCLUSIONS: In this pilot study, OPAT is found to be efficacious in saving hospitalization's days, with a low rate of readmissions and complications and a high patients' level of satisfaction. We therefore conclude that OPAT is feasible and safe. BACKGROUND: Outpatient parenteral antibiotic therapy (OPAT) was not used in Belgium before 2013, except for patients with cystic fibrosis. Thus, we have performed a pilot study to evaluate clinical characteristics and outcomes of patient receiving OPAT in a Belgian setting. METHODS: The study was a prospective observational single-center study of patients receiving OPAT between 1 September 2013 and 31 December, 2017. RESULTS: We included 218 OPATs. The median age was 58 years and 71% were men. At the end of the treatment, 92% of the patients on OPAT were cured. Risk factors for treatment failure were obesity, diabetes and diabetic foot infections, longer duration of hospitalization before OPAT, and duration of OPAT >16 days. An average of 24 days of hospitalization per patient discharge was saved, which amounted to 5205 days saved during the project. During the OPAT and 30 days thereafter, 71 (32.6%) of patients were readmitted, but only 26 (12%) readmissions were directly related to OPAT. Risk factors for readmissions were diabetes and diabetic foot infections, endovascular infections, longer duration of hospitalization before OPAT, duration of OPAT >30 days, and history of hospitalizations in the year before OPAT. There were 2.3 intravenous catheter-related events per 1000 days of catheter use. Patients' level of satisfaction was high (99.5%). CONCLUSIONS: In our study, OPAT is found to be efficacious in saving hospitalization's days, with a low rate of readmissions and complications and a high patients' level of satisfaction. We therefore conclude that OPAT is feasible and safe.


Asunto(s)
Atención Ambulatoria/organización & administración , Antibacterianos/administración & dosificación , Infecciones Bacterianas/tratamiento farmacológico , Servicios de Atención de Salud a Domicilio/organización & administración , Administración Intravenosa , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Atención Ambulatoria/métodos , Artritis Infecciosa/tratamiento farmacológico , Bélgica , Enfermedades Óseas Infecciosas/tratamiento farmacológico , Cateterismo Periférico , Niño , Preescolar , Colangitis/tratamiento farmacológico , Colecistitis/tratamiento farmacológico , Cistitis/tratamiento farmacológico , Diabetes Mellitus , Pie Diabético/tratamiento farmacológico , Farmacorresistencia Bacteriana Múltiple , Duración de la Terapia , Endocarditis/tratamiento farmacológico , Femenino , Hospitalización , Humanos , Tiempo de Internación/estadística & datos numéricos , Absceso Hepático/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Obesidad , Readmisión del Paciente/estadística & datos numéricos , Satisfacción del Paciente , Proyectos Piloto , Estudios Prospectivos , Prostatitis/tratamiento farmacológico , Pielonefritis/tratamiento farmacológico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Factores de Riesgo , Insuficiencia del Tratamiento , Resultado del Tratamiento , Infección de Heridas/tratamiento farmacológico , Adulto Joven
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