Setting up an outpatient parenteral antimicrobial therapy (OPAT) unit in Switzerland: review of the first 18 months of activity.

Details

Ressource 1Download: Setting up an outpatient parenteral antimicrobial therapy (OPAT) unit in Switzerland_prostprint.pdf (423.48 [Ko])
State: Public
Version: Author's accepted manuscript
Serval ID
serval:BIB_65E6CEEE014F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Setting up an outpatient parenteral antimicrobial therapy (OPAT) unit in Switzerland: review of the first 18 months of activity.
Journal
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
Author(s)
Gardiol C., Voumard R., Cochet C., de Vallière S.
ISSN
1435-4373 (Electronic)
ISSN-L
0934-9723
Publication state
Published
Issued date
05/2016
Peer-reviewed
Oui
Volume
35
Number
5
Pages
839-845
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication types: Journal Article ; Research Support, Non-U.S. Gov't

Abstract
Outpatient parenteral antimicrobial therapy (OPAT) has been recognised as a useful, cost-effective and safe alternative to inpatient treatment, but no formal OPAT unit existed in Switzerland until recently. In December 2013 an OPAT unit was established at Lausanne University Hospital. We review here the experience of this new OPAT unit after 18 months of activity. Patient characteristics, clinical activities and outcomes were recorded prospectively. Need and acceptance was evaluated as number of OPAT courses administered and number of patients refusing OPAT. Safety and efficacy were evaluated as: (1) adverse events linked to antimicrobials and catheters, (2) re-admission to hospital, (3) rate of treatment failures and (4) mortality. Over 18 months, 179 courses of OPAT were administered. Acceptance was high with only four patients refusing OPAT. Urinary tract infections with resistant bacteria and musculoskeletal infections were the most common diagnoses. Self-administration of antibiotics using elastomeric pumps became rapidly the most frequently used approach. Sixteen patients presented with adverse events linked to antimicrobials and catheters. OPAT-related readmissions occurred in nine patients. The overall cure rate was 94 %. This study shows that OPAT is very well accepted by patients and medical staff, even in a setting which has not used this type of treatment approach until now. Self-administration using elastomeric pumps proved to be particularly useful, safe and efficient. OPAT offers a good alternative to hospitalisation for patients presenting with infections due to resistant bacteria that cannot be treated orally anymore and for difficult to treat infections.

Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Ambulatory Care, Anti-Infective Agents/administration & dosage, Anti-Infective Agents/adverse effects, Bacterial Infections/diagnosis, Bacterial Infections/drug therapy, Bacterial Infections/microbiology, Female, Humans, Infusions, Parenteral, Male, Middle Aged, Recurrence, Switzerland/epidemiology, Treatment Outcome, Young Adult
Pubmed
Open Access
Yes
Create date
20/02/2016 17:18
Last modification date
20/08/2019 15:21
Usage data