Department of Infectious Diseases, Kameda Medical Center, Chiba, Japan; Department of Infectious Diseases, Japanese Red Cross Narita Hospital, Chiba, Japan.
Department of Pharmacy, Kameda Medical Center, Chiba, Japan.
Int J Infect Dis. 2020 Jun;95:210-215. doi: 10.1016/j.ijid.2020.03.033. Epub 2020 Mar 20.
The infectious diseases team at Kameda Medical Center, Japan, implemented a new outpatient parenteral antimicrobial therapy (OPAT) program in July 2012 and expanded the program with the support of home care services. This study reviews the OPAT program after 5.5 years of operation.
We prospectively collected data about the age, sex, diagnoses, causative organisms, types of OPAT, modes of administration, selected antibiotics, treatment durations, bed days saved, outcomes, readmissions, and estimated cost reductions of all patients who were treated in the OPAT program from July 2012 to December 2017.
Of the 66 patients treated under the OPAT program, 45 (68.2%) were treated using clinic OPAT, and 21 (31.8%) were treated using homecare OPAT. The most commonly targeted organism was methicillin-susceptible Staphylococcus aureus. Continuous infusion with elastomeric pumps was employed in 55 patients (83.3%). Cefazolin was the most frequently used antibiotic (39.4%), followed by penicillin G (24.2%). The median OPAT duration was 13 days (range, 3-51), and the total bed days saved was 923. The estimated medical cost reduction was approximately 87,000 US dollars.
Our experience shows that OPAT is a safe and feasible practice not only for efficient bed utilization and medical cost savings but also for better antimicrobial stewardship.
日本镰仓市镰仓医疗中心传染病科团队于 2012 年 7 月实施了一项新的门诊患者静脉用抗菌药物治疗（OPAT）计划，并在家庭护理服务的支持下对该计划进行了扩展。本研究回顾了该计划实施 5.5 年后的情况。
我们前瞻性地收集了 2012 年 7 月至 2017 年 12 月期间所有在 OPAT 计划中接受治疗的患者的年龄、性别、诊断、病原体、OPAT 类型、给药方式、选择的抗生素、治疗持续时间、节省的住院天数、结局、再入院和估计成本节约的数据。
在接受 OPAT 计划治疗的 66 名患者中，45 名（68.2%）接受了门诊 OPAT 治疗，21 名（31.8%）接受了家庭护理 OPAT 治疗。最常见的目标病原体是耐甲氧西林金黄色葡萄球菌。55 名患者（83.3%）采用弹性泵持续输注。头孢唑林是最常用的抗生素（39.4%），其次是青霉素 G（24.2%）。OPAT 持续时间中位数为 13 天（范围 3-51 天），总节省住院天数为 923 天。估计医疗费用节约约为 87000 美元。
我们的经验表明，OPAT 不仅可提高病床利用效率和节约医疗费用，还可实现更好的抗菌药物管理，是一种安全可行的治疗方法。
