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英国门诊胃肠外抗菌治疗实践:单中心经验

Outpatient Parenteral Antimicrobial Therapy Practice in United Kingdom: A Single-center Experience.

作者信息

Kesharwani Damini, Bista Anushruti, Singh Hardeep, Unnithan Ashwin, Das Gautam, Bristoll Sarah, Lewis Nicki, Alnoori Nadhim

机构信息

Department of Urology, Ashford and St. Peter's Hospital NHS Foundation Trust, Lyne, Chertsey, England.

Department of General Medicine, Ashford and St. Peter's Hospital NHS Foundation Trust, Lyne, Chertsey, England.

出版信息

Oman Med J. 2022 Nov 30;37(6):e442. doi: 10.5001/omj.2023.26. eCollection 2022 Nov.

Abstract

OBJECTIVES

This study sought to analyze the outpatient parenteral antimicrobial therapy (OPAT) services provided by a tertiary hospital, in terms of types and duration of antimicrobials administered, and assess whether these services were in line with current good practice recommendations.

METHODS

The electronic healthcare records of all stable patients with infectious diseases, aged ≥ 18 years, who received OPAT services between January 2019 and March 2021, were analyzed. For statistical analysis, the patients were divided into younger (< 65 years) and older (≥ 65 years) adults and the difference between them, in terms of healthcare resources utilization, was assessed.

RESULTS

Over 27 months, 199 patients received OPAT services, resulting in saving of 7514 bed-days. Bone and joint infections (38.7%) were the predominant diagnoses. The median actual OPAT duration was significantly greater than the planned duration for the total study population, younger adults, and older adults ( < 0.050). Of 28 (14.1%) patients with adverse events, 25 were related to antimicrobials while the remaining three were associated with catheters. There were no significant differences between younger and older adults in the characteristics evaluated, except for the higher incidence of ( < 0.001) and spp., spp., and spp. (0.003) infection in older adults.

CONCLUSIONS

The actual median duration of OPAT therapy was significantly longer than planned, with suboptimal adherence to the principles of antimicrobial stewardship. OPAT has been shown to be safe for both younger and older adults.

摘要

目的

本研究旨在分析一家三级医院提供的门诊胃肠外抗菌治疗(OPAT)服务,包括所使用抗菌药物的类型和疗程,并评估这些服务是否符合当前的良好实践建议。

方法

对2019年1月至2021年3月期间接受OPAT服务的所有年龄≥18岁的稳定传染病患者的电子医疗记录进行分析。为进行统计分析,将患者分为年轻成年人(<65岁)和老年成年人(≥65岁),并评估他们在医疗资源利用方面的差异。

结果

在27个月的时间里,199名患者接受了OPAT服务,节省了7514个床日。骨和关节感染(38.7%)是主要诊断。总体研究人群、年轻成年人及老年成年人的实际OPAT疗程中位数均显著长于计划疗程(P<0.050)。在28例(14.1%)发生不良事件的患者中,25例与抗菌药物有关,其余3例与导管有关。除老年成年人中[具体细菌名称1](P<0.001)、[具体细菌名称2]属、[具体细菌名称3]属和[具体细菌名称4]属感染发生率较高外,年轻成年人与老年成年人在评估的特征方面无显著差异(P = 0.003)。

结论

OPAT治疗的实际疗程中位数显著长于计划疗程,抗菌药物管理原则的依从性欠佳。OPAT已被证明对年轻和老年成年人都是安全的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0cb/9627952/34cfb1543ced/OMJ-37-06-2100146-f1.jpg

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