Patient Characteristics and Outcomes of Outpatient Parenteral Antimicrobial Therapy: A Retrospective Study
Patient Characteristics and Outcomes of Outpatient Parenteral Antimicrobial Therapy: A Retrospective Study
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DOI：
10.1155/2016/8435257
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发表时间：
2016-01-01
影响因子：
2.8
通讯作者：
Daneman, Nick
中科院分区：
文献类型：
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作者：
Yan, Marie;Elligsen, Marion;Daneman, Nick
门诊肠外抗菌治疗（OPAT）是许多感染性疾病患者住院治疗的一种安全有效的替代方法。本研究的目的是描述的OPAT经验，在加拿大的高等教育学术中心的情况下，一个正式的OPAT计划。这是通过对Sunnybrook健康科学中心一年内出院的OPAT患者进行回顾性图表审查来实现的。2012年6月至2013年5月期间，104例患者（中位年龄63岁）出院回家，接受肠外抗菌剂治疗。最常治疗的综合征包括手术部位感染（33%）、骨关节感染（28%）和菌血症（21%）。最常用的抗菌药物是头孢曲松（21%）和头孢唑啉（20%）。只有56%的患者接受了传染病专家的后续护理。在出院后的60天内，43%的患者返回急诊科，而26%的患者需要再次入院。48%的回访是由于感染复发或治疗失败，23%可归因于OPAT相关并发症。这些结果表明，许多OPAT患者由于与感染或治疗相关的问题而出现计划外的医疗保健接触，建立正式的OPAT诊所可能有助于改善结果。
Outpatient parenteral antimicrobial therapy (OPAT) is a safe and effective alternative to hospitalization for many patients with infectious diseases. The objective of this study was to describe the OPAT experience at a Canadian tertiary academic centre in the absence of a formal OPAT program. This was achieved through a retrospective chart review of OPAT patients discharged from Sunnybrook Health Sciences Centre within a one-year period. Between June 2012 and May 2013, 104 patients (median age 63 years) were discharged home with parenteral antimicrobials. The most commonly treated syndromes included surgical site infections (33%), osteoarticular infections (28%), and bacteremia (21%). The most frequently prescribed antimicrobials were ceftriaxone (21%) and cefazolin (20%). Only 56% of the patients received follow-up care from an infectious diseases specialist. In the 60 days following discharge, 43% of the patients returned to the emergency department, while 26% required readmission. Forty-eight percent of the return visits were due to infection relapse or treatment failure, and 23% could be attributed to OPAT-related complications. These results suggest that many OPAT patients have unplanned health care encounters because of issues related to their infection or treatment, and the creation of a formal OPAT clinic may help improve outcomes.