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Evaluation of Opportunities for Oral Antibiotic Therapy in Bone and Joint Infections.
Bhagat, Hita; Sikka, Monica K; Sukerman, Ellie S; Makadia, Jina; Lewis, James S; Streifel, Amber C.
Afiliação
  • Bhagat H; Department of Pharmacy, Oregon Health & Science University, Portland, OR, USA.
  • Sikka MK; School of Medicine, Division of Infectious Diseases, Oregon Health & Science University, Portland, OR, USA.
  • Sukerman ES; School of Medicine, Division of Infectious Diseases, Oregon Health & Science University, Portland, OR, USA.
  • Makadia J; School of Medicine, Division of Infectious Diseases, Oregon Health & Science University, Portland, OR, USA.
  • Lewis JS; Department of Pharmacy, Oregon Health & Science University, Portland, OR, USA.
  • Streifel AC; School of Medicine, Division of Infectious Diseases, Oregon Health & Science University, Portland, OR, USA.
Ann Pharmacother ; 57(2): 156-162, 2023 02.
Article em En | MEDLINE | ID: mdl-35656850
BACKGROUND: The OVIVA trial suggests oral antibiotics are an alternative to intravenous antibiotics to treat bone and joint infections (BJI). A shift in practice to treatment with oral antibiotics would eliminate the need for central vascular access, improve patient satisfaction, and reduce overall healthcare costs. OBJECTIVE: The primary objective was to identify the proportion of patients treated for BJIs with outpatient parenteral antimicrobial therapy (OPAT) who would have qualified for oral antibiotics based on microbiological data. The secondary objective was to conduct a cost-analysis to estimate potential cost-savings had eligible patients been treated with oral antibiotics. METHODS: This was a single-center, retrospective study of adult patients in the United States treated with intravenous antibiotics for BJIs from January 2018 to April 2020. Inclusion and exclusion criteria matched the OVIVA trial. Patients with Staphylococcus aureus bacteremia, endocarditis, or other high-risk features were excluded. RESULTS: 281 patients met the inclusion criteria. Most had prosthetic joint infections (56%). Infections caused by coagulase-negative staphylococci (25%) were most common, followed by S. aureus (23%) and polymicrobial infections (22%). 69 (25%) patients required a switch during their OPAT course to an alternate antibiotic agent. Thirteen patients (5%) experienced vascular access complications, and 6 patients (2%) developed Clostridiodes difficile infections. Oral therapy could have resulted in an estimated average savings per patient of $3,270.69 USD. CONCLUSION AND RELEVANCE: Most patients treated with OPAT for BJIs were candidates for oral antibiotics. A change in practice would result in cost-savings to the U.S. healthcare system.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Estafilocócicas / Staphylococcus aureus Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: Ann Pharmacother Assunto da revista: FARMACOLOGIA / TERAPIA POR MEDICAMENTOS Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções Estafilocócicas / Staphylococcus aureus Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: Ann Pharmacother Assunto da revista: FARMACOLOGIA / TERAPIA POR MEDICAMENTOS Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos