Zhang Yuhan, Ody Yun Chun, Davis Linsey
Specialist Nurse Practitioner, the Ambulatory Outreach Team, John Radcliffe Hospital, Oxford.
Ambulatory Outreach Team Sister, the Ambulatory Outreach Team, John Radcliffe Hospital, Oxford.
Br J Community Nurs. 2020 Aug 2;25(8):376-380. doi: 10.12968/bjcn.2020.25.8.376.
There has been a surging interest in using elastomeric infusion devices to deliver outpatient parenteral antimicrobial therapy (OPAT), which is more cost-effective than standard antibiotic administration, which requires multiple daily home visits. This has been particularly important since the outbreak of the coronavirus pandemic, because reducing patient contact can also help to minimise transmission of COVID-19 to outpatients who are at a high risk of COVID-19-triggered complications. In this retrospective study, the clinical effectiveness of intravenous (IV) infusion of flucloxacillin using an elastomeric device was explored in a convenience sample of patients. Patients with three primary infective diagnoses-bloodstream infection, non-vertebral osteomyelitis and vertebral osteomyelitis-were included in the analyses. In non-vertebral osteomyelitis patients, Accufuser antibiotic infusion shortened the course of OPAT care relative to standard antibiotic administration (p<.05). In contrast, in vertebral osteomyelitis patients, it prolonged the course of OPAT care relative to standard administration (p<.05). In patients with bloodstream infections, no significant difference was found between the treatment modes (p=.93). Thus, the clinical effectiveness of Accufuser antibiotic infusion varies among patients with different infective diagnoses, and there seems to be a complex relationship between the method of antibiotic delivery and the patient's condition.
人们对使用弹性输液装置进行门诊胃肠外抗菌治疗(OPAT)的兴趣激增,这种治疗方式比标准抗生素给药更具成本效益,标准抗生素给药需要每天多次家访。自冠状病毒大流行爆发以来,这一点尤为重要,因为减少患者接触也有助于将COVID-19传播给有COVID-19引发并发症高风险的门诊患者的情况降至最低。在这项回顾性研究中,在一个方便样本的患者中探讨了使用弹性装置静脉输注氟氯西林的临床有效性。分析纳入了患有三种主要感染诊断——血流感染、非椎骨骨髓炎和椎骨骨髓炎的患者。在非椎骨骨髓炎患者中,与标准抗生素给药相比,Accufuser抗生素输注缩短了OPAT护理疗程(p<0.05)。相比之下,在椎骨骨髓炎患者中,与标准给药相比,它延长了OPAT护理疗程(p<0.05)。在血流感染患者中,两种治疗方式之间未发现显著差异(p=0.93)。因此,Accufuser抗生素输注的临床有效性在不同感染诊断的患者中有所不同,抗生素给药方法与患者病情之间似乎存在复杂的关系。