Infection and Immunodeficiency Service, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
Infection and Immunodeficiency Service, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
Int J Antimicrob Agents. 2014 Jan;43(1):7-16. doi: 10.1016/j.ijantimicag.2013.09.006. Epub 2013 Oct 14.
Outpatient parenteral antimicrobial therapy (OPAT) has become a global treatment modality since its advent in 1974. The multicentre outcome registries that were employed at the turn of the century to demonstrate the benefits and challenges in this treatment setting have been discontinued. In the intervening years, trends in clinical, patient satisfaction, programmatic and economic outcomes have been shown in sporadic cohort analyses from around the globe. These outcomes are generally reassuring and compare well with previous registry data. However, meaningful comparison of a range of key outcomes is hampered by a lack of uniformity to outcome reporting. In addition to 'whole programme' outcome reports, several studies have detailed real-world outcomes in OPAT pertaining to specific conditions and populations. This work has shown how prospective data collection in the OPAT setting can yield valuable insights into the effectiveness and safety of the management of many conditions, such as osteoarticular infection and endocarditis, in a diverse range of populations and increasingly from different countries. Enhanced and perhaps more uniform outcome surveillance in this fashion now constitutes good practice and will enable the benefits and risks of this treatment modality to be shared both in novel and established OPAT arenas.
自 1974 年问世以来，门诊患者的抗菌药物治疗（OPAT）已成为一种全球性的治疗方式。在本世纪之交，为了证明这种治疗方式的益处和挑战，采用了多中心的结果登记，但现在已经停止。在这期间，全球各地的零星队列分析显示了临床、患者满意度、计划和经济结果的趋势。这些结果通常是令人放心的，与之前的登记数据相比也相当不错。然而，由于缺乏对结果报告的统一标准，对一系列关键结果进行有意义的比较受到了阻碍。除了“整个方案”的结果报告外，一些研究还详细介绍了 OPAT 中特定疾病和人群的真实结果。这项工作表明，在 OPAT 环境中进行前瞻性数据收集如何能够深入了解许多疾病（如骨关节炎感染和心内膜炎）的管理的有效性和安全性，涉及到不同人群和越来越多的不同国家。以这种方式加强和提高结果监测的规范性现在是良好的实践，并将使这种治疗方式的益处和风险能够在新的和已建立的 OPAT 领域中共享。
