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J Antimicrob Chemother ; 72(10): 2898-2901, 2017 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-29091189

RESUMEN

Objectives: Most outpatient parenteral antimicrobial therapy (OPAT) services use a hospital-based model of care in which patients remain in proximity to large hospitals facilitating clinical review. We aimed to evaluate clinical outcomes and complication rates for patients living in geographically isolated locations managed by telemedicine-supported OPAT. Methods: This was a retrospective cohort study. Results: Between 2011 and 2015, we delivered 88 episodes of care involving 83 adult patients resulting in 2261 days of OPAT. The median age was 56 years, 8 of 83 (10%) were indigenous Australian and the median Charlson comorbidity index score was 2 (IQR 1-4). The median distance of patients' residence from our hospital was 288 km (IQR 201-715) and the median duration on the programme was 26 days (IQR 14-34). Bone and joint infections accounted for 75% of infections treated. Favourable clinical outcomes (improvement or cure) were achieved in 87% of patients and the unplanned, OPAT-related readmission rate was 8%. Nineteen percent and 10% of patients had drug-related and line-related adverse effects, respectively. Conclusions: Despite a complex case mix, our adverse event and readmission rates are similar to the published literature describing a non-telemedicine model to deliver OPAT. High rates of favourable clinical outcomes and likely cost benefits suggest that telemedicine-supported OPAT is an efficacious and safe substitute for inpatient care in our setting.


Asunto(s)
Atención Ambulatoria/métodos , Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Telemedicina , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Atención Ambulatoria/economía , Antibacterianos/uso terapéutico , Artritis Infecciosa/tratamiento farmacológico , Artritis Infecciosa/epidemiología , Australia/epidemiología , Niño , Estudios de Cohortes , Análisis Costo-Beneficio , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Endocarditis/tratamiento farmacológico , Femenino , Geografía , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Infecciones de los Tejidos Blandos/tratamiento farmacológico , Resultado del Tratamiento , Adulto Joven
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