Safety and effectiveness of outpatient parenteral antimicrobial therapy in older people

Abel Mujal, Joan Sola, Manuel Hernandez, Maria Antonia Villarino, Mireia Baylina, Juan Tajan, Joaquim Oristrell

Research output: Contribution to journalArticleResearchpeer-review

12 Citations (Scopus)

Abstract

© 2016 Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. Objectives: We analyse the safety and effectiveness of self-outpatient parenteral antimicrobial therapy (s-OPAT) in older patients. Methods: We prospectively evaluated all adults admitted to our home hospitalization unit (HHU) for s-OPAT in the period 2008-12 in whom the bacteria responsible for the infection were identified.We divided patients into three age groups: <65, 65-79 and ≥80 years. s-OPAT was administered by patients or their caregivers using elastomeric infusion devices. Effectiveness was assessed by analysing readmissions to hospital for inadequate control of underlying infection. Safety was assessed by analysing adverse events, catheter-related complications and readmission to hospital for causes unrelated to inadequate control of underlying infection. Results: During the study period, 420 episodes of s-OPAT were registered in 351 patients: 139 (33.1%) in patients aged <65 years, 182 (43.3%) in those aged 65-79 years and 99 (23.6%) in those aged ≥80 years. Patients aged ≥80 years had a significantly lower Barthel index. The length of stay for s-OPAT and the complete HHU stay were similar in the three groups. Older people had similar changes in antibiotic treatment and hospital readmission rates due to poor control of underlying infection but higher readmission rates due to worsening of underlying diseases than younger adults. Adverse events and catheter-related complications were similar in the three age groups. Conclusions: s-OPATadministered by patients or their caregivers using elastomeric deviceswas safe and effective in the treatment of infections in older people.
Original languageEnglish
Article numberdkv478
Pages (from-to)1402-1407
JournalJournal of Antimicrobial Chemotherapy
Volume71
Issue number5
DOIs
Publication statusPublished - 1 May 2016

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