Efficacy and safety of a Belgian tertiary care outpatient parenteral antimicrobial therapy (OPAT) program
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ORIGINAL PAPER
Efficacy and safety of a Belgian tertiary care outpatient parenteral antimicrobial therapy (OPAT) program Charlotte Quintens1,2 · Ester Steffens3,4 · Karel Jacobs5 · Annette Schuermans3,4 · Johan Van Eldere6,7 · Katrien Lagrou6,8 · Paul De Munter6,9 · Inge Derdelinckx6,9 · Willy E. Peetermans6,9 · Isabel Spriet1,2 Received: 12 August 2019 / Accepted: 31 January 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Evidence supports the implementation of outpatient parenteral antimicrobial therapy (OPAT) as standard of care. Until 2015 the overall experience with OPAT in Belgium remained limited. The aim of this study was to evaluate the efficacy and safety of a Belgian ‘OPAT at home’ program, which was implemented in University Hospitals Leuven starting from January 2017. Methods A mono-centric, prospective, observational study was carried out. All OPAT cases discharged between 10 January 2017 and 10 January 2019 were included in the study. Relevant demographic and clinical patient data were collected. The outcomes were clinical cure rate, OPAT related readmission rate, adverse event rate and patients’ satisfaction. Results Over the two-year study period, 152 OPAT episodes were started in 130 patients, resulting in 3153 avoided hospitalization days which corresponds to 5.4 freed hospital beds. Urinary tract infections accounted for 40.8% of OPAT courses and temocillin was the most frequently used antibiotic (24.3%). Cure was achieved in 97.9% of the OPAT episodes. During 22 (14.5%) OPAT episodes, patients experienced adverse events, including line related adverse events (7.9%) and adverse drug events (6.6%). An OPAT related readmission rate of 9.2% was observed, mostly related to line-associated adverse events. All patients who completed the satisfaction survey (n = 23) were very satisfied with their OPAT course. Conclusion The University Hospitals Leuven OPAT program is associated with a high level of clinical cure and low allcause readmission and adverse event rates. Improvement actions are described to further reduce the readmission rate to less than 5.0%. Keywords Outpatient parenteral antimicrobial therapy · OPAT · Hospital at home · Home care · Antibiotics · Intravascular catheter care
Introduction The delivery of parenteral antimicrobial therapy outside the hospital, which is generally referred to as “Outpatient Parenteral Antimicrobial Therapy” (OPAT), was used for the first time in 1974 in North-America to treat respiratory tract infections in children with cystic fibrosis [1–4]. It has been proven to be safe and cost-effective from a hospital’s Charlotte Quintens and Ester Steffens are first shared authors as they made equal contributions to the conception of the work, the analysis and interpretation of data and to the writing of the manuscript. * Charlotte Quintens [email protected] Extended author information available on the last page of the article
perspective and has the potential to improve patients’ quality of life and to reduce th
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