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希腊阿提卡地区的家庭门诊肠外抗生素治疗(OPAT)。

Outpatient parenteral antibiotic therapy (OPAT) at home in Attica, Greece.

机构信息

SOS Doctors, 1 Ipirou Street, Athens, 10433, Greece.

出版信息

Eur J Clin Microbiol Infect Dis. 2012 Nov;31(11):2957-61. doi: 10.1007/s10096-012-1647-1. Epub 2012 Jun 2.

Abstract

Outpatient parenteral antibiotic therapy (OPAT) is considered to be a cost-effective and safe alternative treatment strategy to hospitalization. We retrospectively evaluated data regarding the demographic and treatment characteristics of patients that sought medical advice from a network of physicians performing house-call visits and who received OPAT at home during a 17-month period (May 2009 to September 2010) in Attica, Greece. A total of 91 patients (69.2 % females) received intravenous antibiotic therapy at home during the evaluated period. The mean age [± standard deviation (SD)] of the patients was 85.3 (± 9) years. The main indications were pneumonia [46 patients (50.5 %)], urinary tract infection [25 (27.5 %)], and gastrointestinal tract infection [9 (9.9 %)]. Of the patients, 76.4 % received a beta-lactam, 17.5 % a fluoroquinolone, 15.3 % an imidazole, 8.7 % an aminoglycoside, and 5.4 % a lincosamide. The cure rate was 72.5 % and mortality was 27.5 %. The mean duration (± SD) of intravenous antibiotic treatment was 4.7 (± 3.3) days. The mean cost per patient was 637 and was comparable to the mean cost if the patient were to be hospitalized for the same infection. There was significant clinical effectiveness of OPAT at home in this mainly elderly population, at an acceptable cost.

摘要

门诊患者的肠外抗生素治疗(OPAT)被认为是一种具有成本效益且安全的替代住院治疗策略。我们回顾性评估了在希腊阿提卡地区的一个医生网络中,接受上门就诊并在家中接受 OPAT 治疗的患者的人口统计学和治疗特征的数据。在 17 个月的时间内(2009 年 5 月至 2010 年 9 月),共有 91 名患者(69.2%为女性)接受了静脉内抗生素治疗。患者的平均年龄(±标准差(SD))为 85.3(±9)岁。主要适应证为肺炎[46 例(50.5%)]、尿路感染[25 例(27.5%)]和胃肠道感染[9 例(9.9%)]。在这些患者中,76.4%接受了β-内酰胺类药物,17.5%接受了氟喹诺酮类药物,15.3%接受了咪唑类药物,8.7%接受了氨基糖苷类药物,5.4%接受了林可酰胺类药物。治愈率为 72.5%,死亡率为 27.5%。静脉内抗生素治疗的平均持续时间(±SD)为 4.7(±3.3)天。每位患者的平均费用为<欧元>637 欧元,如果患者因相同感染住院,费用相当。在这个主要由老年人组成的人群中,OPAT 在家中具有显著的临床疗效,而且成本可以接受。

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