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https://www.readbyqxmd.com/read/27898208/-design-and-implementation-of-an-outpatient-parenteral-antimicrobial-therapy-program-in-primary-care-the-experience-at-a-second-level-hospital
#1
M Ruiz-Campuzano, E García-Vázquez, J J Hernández-Roca, J Gómez-Gómez, M Canteras-Jordana, E Mené-Fenor, A Hernández-Torres, A Peláez-Ballesta
OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) programs are a good assistance option in a wide variety of infectious diseases. Our aim was to design and implement an OPAT program in the area of influence of a second-level hospital, with no Home Hospitalization Service available, being necessary close collaboration between hospitalization and Primary Care teams, describe our cohort, analyse the antimicrobial treatment indicated and evaluate the prognostic and risk factors associated with readmission and mortality...
November 28, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27821624/the-utility-of-a-blood-culture-database-to-identify-patients-suitable-for-outpatient-parenteral-antibiotic-treatment
#2
Mark Melzer, Liana Macpherson, Catherine Welch
BACKGROUND: The clinical and cost-effectiveness of outpatient parenteral antimicrobial therapy (OPAT) services are well described. We used a blood culture database as a novel approach to case finding and determined its utility in identifying inpatients suitable for OPAT. METHODS: From December 2012 to November 2013, consecutive adult inpatients with bacteraemia, and those recruited to OPAT, were prospectively studied. Univariate and multivariate logistic regression analysis were used to investigate the association between bacteraemic patient characteristics and OPAT recruitment...
November 7, 2016: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27820968/safety-and-efficacy-of-daptomycin-in-outpatient-parenteral-antimicrobial-therapy-a-prospective-and-multicenter-cohort-study-daptodom-trial
#3
Carlos Cervera, Pedro Sanroma, Víctor González-Ramallo, Cristina García de la María, Gemma Sanclemente, Nieves Sopena, Marcos Pajarón, Antonio Segado, Manuel Mirón, Francisco Antón, Andima Basterretxea, Ana Cuende, José M Miró
BACKGROUND: Daptomycin is an optimal choice for outpatient parenteral antibiotic therapy (OPAT) because of its safety, once-daily administration and its activity against Gram-positive bacteria. Although daptomycin is increasingly being used in OPAT, limited information about its safety in this scenario is available. METHODS: We performed a prospective multicentre pilot study to evaluate the safety of daptomycin in outpatients with proved or suspected Gram-positive infections (DAPTODOM)...
November 8, 2016: Infectious Diseases
https://www.readbyqxmd.com/read/27807591/value-and-clinical-impact-of-an-infectious-disease-supervised-outpatient-parenteral-antibiotic-therapy-program
#4
Russell M Petrak, Nathan C Skorodin, Robert M Fliegelman, David W Hines, Vishnu V Chundi, Brian P Harting
Background.  Outpatient parenteral antibiotic therapy (OPAT) is a safe and effective modality for treating serious infections. This study was undertaken to define the value of OPAT in a multicentered infectious disease (ID) private practice setting. Methods.  Over a period of 32 months, 6120 patients were treated using 19 outpatient ID offices in 6 states. Analysis included patient demographics, indications of OPAT, diagnoses, therapeutic agent, duration of therapy, and site of therapy initiation. Outcomes were stratified by therapeutic success, clinical relapse, therapeutic complications, and hospitalizations after initiating therapy...
October 2016: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/27801359/bed-utilisation-in-an-irish-regional-paediatric-unit-a-cross-sectional-study-using-the-paediatric-appropriateness-evaluation-protocol-paep
#5
Coilín ÓhAiseadha, Mai Mannix, Jean Saunders, Roy K Philip
BACKGROUND: Increasing demand for limited healthcare resources raises questions about appropriate use of inpatient beds. In the first paediatric bed utilisation study at a regional university centre in Ireland, we conducted a cross-sectional study to audit the utilisation of inpatient beds at the Regional Paediatric Unit (RPU) in University Hospital Limerick (UHL), Limerick, Ireland and also examined hospital activity data, to make recommendations for optimal use of inpatient resources...
May 10, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/27792443/optimising-patient-safety-when-using-elastomeric-pumps-to-administer-outpatient-parenteral-antibiotic-therapy
#6
Gemma Oliver
Outpatient parenteral antibiotic therapy (OPAT) is a growing area of practice that has numerous benefits for both patients and the healthcare system. In order for OPAT services to be successful, strategies need to be in place to maximise efficiency while providing safe, high-quality care. The use of elastomeric pumps to deliver intravenous (IV) antibiotics can have many benefits for OPAT services; they are cost-effective, easy to use and allow the patient to be fully ambulant. However, plans need to be put in place to make sure their use is safe and effective...
October 27, 2016: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/27747899/safety-and-efficacy-of-outpatient-parenteral-antibiotic-therapy-in-an-academic-infectious-disease-clinic
#7
G Suleyman, R Kenney, M J Zervos, A Weinmann
WHAT IS KNOWN AND OBJECTIVE: Outpatient parenteral therapy (OPAT) has become a safe and effective modality for patients requiring intravenous or prolonged antimicrobial therapy since the 1970s. It is being increasingly utilized in various settings; however, studies evaluating the safety and efficacy of clinic-based OPAT are limited. Since 2012, patients being considered for OPAT have required an infectious disease (ID) consultation at our institution. Candidates receiving once-daily antimicrobials who were ineligible for home infusion or nursing home placement as determined by their insurance companies and those who preferred the clinic over nursing home or home infusion were referred to the ID clinic...
October 16, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27553996/guidelines-for-timely-initiation-of-chemotherapy-a-proposed-framework-for-access-to-medical-oncology-and-haematology-cancer-clinics-and-chemotherapy-services
#8
M Alexander, R Beattie-Manning, R Blum, J Byrne, C Hornby, C Kearny, N Love, J McGlashan, S McKiernan, J L Milar, D Murray, S Opat, P Parente, J Thomas, N Tweddle, C Underhill, K Whitfield, S Kirsa, D Rischin
These guidelines, informed by the best available evidence and consensus expert opinion, provide a framework to guide the timely initiation of chemotherapy for treating cancer. They sit at the intersection of patient experience, state-of-the-art disease management and rational efficient service provision for these patients at a system level. Internationally, cancer waiting times are routinely measured and publicly reported. In Australia, there are existing policies and guidelines relating to the timeliness of cancer care for surgery and radiation therapy; however, until now, equivalent guidance for chemotherapy was lacking...
August 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27540212/what-is-the-maximum-temperature-reached-in-elastomeric-devices-under-simulated-opat-conditions
#9
Susanna van Der Merwe, Helen Green
AIM: Outpatient parenteral antimicrobial therapy (OPAT), both in children and adults, is increasing in use as part of a cost saving measure for the NHS.1 However there is a general lack of stability data for antibiotics in elastomeric devices. The 'Yellow Covered Document'2 (YCD), as it is commonly known, specifies the storage conditions, under which stability testing should be carried out ranging from freezing to a worst case scenario of 37°C±2°C. It is assumed that a temperature of 37°C equates to wearing a device reservoir under clothing close to the body e...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27396268/association-of-time-to-chemotherapy-and-survival-in-six-cancers-a-systematic-literature-review-and-recommendations-for-clinical-practice
#10
Marliese Alexander, Robert Blum, Sachin Joshi, Stephen Opat, Phillip Parente, Kate Burbury, John Coutsouvelis, Michael Dooley, Obaid Fazil, Tina Griffitths, Huda Ismail, Natalie Love, Nicole Porter, Eldene Ross, Jim Siderov, Pauline Thomas, Shane White, Sue Kirsa, Danny Rischin
This review evaluated the association between time-to-chemotherapy (TTC) and survival in six priority cancers. A systematic review of the literature was undertaken for papers indexed in MEDLINE and Cochrane Library databases from earliest index until April 2014. The methodology used has been published in a separate paper (Timely initiation of chemotherapy. Part 1: a proposed framework for access to medical oncology and haematology cancer clinics and chemotherapy services). The optimal timing of chemotherapy in breast cancer is unclear as available studies are of low quality, report inconsistent results, and are limited to the adjuvant setting...
July 11, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27393717/predictors-of-hospital-readmission-in-patients-receiving-outpatient-parenteral-antimicrobial-therapy
#11
Laura Means, Susan Bleasdale, Monica Sikka, Alan E Gross
STUDY OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) is increasingly used, and unfortunately, readmissions during OPAT are common. The purpose of this study was to identify predictors of hospital readmission among patients receiving OPAT. DESIGN: Retrospective cohort study. SETTING: Large academic tertiary care hospital. PATIENTS: A total of 216 adults who were discharged and received OPAT through a peripherally inserted central catheter for at least 2 days for treatment of an active infection, excluding patients with cystic fibrosis, between January 2012 and August 2013...
August 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27367324/changing-modalities-of-outpatient-parenteral-antimicrobial-therapy-use-over-time-in-italy-a-comparison-of-two-time-periods
#12
Silvano Esposito, Silvana Noviello, Giovanni Boccia, Giuseppe De Simone, Pasquale Pagliano, Francesco De Caro
This study aimed to assess the extent and nature of recent changes in the management of outpatient parenteral antimicrobial therapy (OPAT) in Italy. We reviewed our previously reported data from 1999 to 2003 and compared them with data from patients who received OPAT from 2005 to 2010. Data for 1175 patients who received OPAT were analysed. Skin and soft tissue infections (SSTIs) were the most common infection treated with OPAT in both time periods, but an increase in patients with SSTIs receiving OPAT was observed...
June 1, 2016: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/27366183/patient-characteristics-and-outcomes-of-outpatient-parenteral-antimicrobial-therapy-a-retrospective-study
#13
Marie Yan, Marion Elligsen, Andrew E Simor, Nick Daneman
Outpatient parenteral antimicrobial therapy (OPAT) is a safe and effective alternative to hospitalization for many patients with infectious diseases. The objective of this study was to describe the OPAT experience at a Canadian tertiary academic centre in the absence of a formal OPAT program. This was achieved through a retrospective chart review of OPAT patients discharged from Sunnybrook Health Sciences Centre within a one-year period. Between June 2012 and May 2013, 104 patients (median age 63 years) were discharged home with parenteral antimicrobials...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
https://www.readbyqxmd.com/read/27325439/tigecycline-use-in-the-outpatient-parenteral-antibiotic-therapy-setting
#14
P R Ingram, M D M Rawlins, R J Murray, J A Roberts, L Manning
In the context of globally increasing antimicrobial resistance, tigecycline appears to be a useful therapeutic option. The need for prolonged courses for complex infections has prompted consideration of its use via outpatient parenteral antibiotic therapy (OPAT) programmes, although clinical outcomes when used in this setting remain unknown. We retrospectively reviewed the patient characteristics and outcomes of 11 patients who received tigecycline, most commonly delivered as 100 mg once daily, via OPAT at three tertiary Australian hospitals...
October 2016: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/27263147/-outpatient-parenteral-antibiotic-therapy-opat-the-lausanne-experience-supporting-new-perspectives
#15
Estelle Moulin, Noémie Boillata, Serge De Vallière
With the increase of infections without option for an oral treatment, the systematic use of hospitalization overloads the healthcare system and causes growing political concern. For carefully selected patients, outpatient parenteral antibiotic therapy is an interesting alternative, with more than 40 years of experience in several countries. In this perspective, an outpatient parenteral antibiotic therapy (OPAT) unit was established in Lausanne two years ago. This article aims to describe its activity. Its practice, involving especially self-administration, seems to be safe, efficacious and cost-effective, as long as international good practice recommendations are applied...
April 13, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/27256144/-outpatient-parenteral-antibiotic-therapy-opat
#16
Marek Štefan, Michal Holub
Traditionally, parenteral (i. e. intravenous) antimicrobial therapy has been used in inpatients with various bacterial infections. In recent decades there has been growing experience with outpatient parenteral antimicrobial therapy, mainly in the USA and western Europe. This article provides basic information on OPAT, based on available literature and the author´s experience on running OPAT service in the UK.
2016: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27248789/transitions-of-care-in-the-management-of-acute-bacterial-skin-and-skin-structure-infections-a-paradigm-shift
#17
Jaime E Verastegui, Yukihiro Hamada, David P Nicolau
Acute bacterial skin and skin structure infections (ABSSSI) have evolved over a relatively short period of time to become one of the most challenging medical problems encountered in clinical practice. Notably the high incidence of methicillin-resistant S. aureus (MRSA) across the continuum of care has coincided with increased outpatient failures and higher rates of hospital admissions for parental antibiotic therapy. Consequently the management of ABSSSI constitutes a tremendous burden to the healthcare system in terms of cost of care and consumption of institutional and clinical resources...
August 2016: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/27239695/ertapenem-in-outpatient-parenteral-antimicrobial-therapy-for-complicated-urinary-tract-infections
#18
Mohamad-Ali Trad, Lihua H Zhong, Ryan M Llorin, Shire Yang Tan, Monica Chan, Sophia Archuleta, Zuraidah Sulaiman, Vincent H Tam, David C Lye, Dale A Fisher
BACKGROUND: Ertapenem is a broad-spectrum antibiotic that is increasingly being utilized. Its dosing convenience renders it suitable for outpatient therapy, and its pharmacokinetic characteristics favour its use against complicated urinary tract infections (cUTIs). Despite this, sufficient clinical data are lacking for its use against cUTIs in the outpatient setting. We assessed the microbiological and clinical cure rates associated with ertapenem treatment for cUTIs in two outpatient parenteral antimicrobial therapy (OPAT) departments...
May 30, 2016: Journal of Chemotherapy
https://www.readbyqxmd.com/read/27231802/use-of-oritavancin-in-moderate-to-severe-absssi-patients-requiring-iv-antibiotics-a-u-s-payer-budget-impact-analysis
#19
Ivar S Jensen, Elizabeth Wu, Weihong Fan, Thomas P Lodise, David P Nicolau, Scott Dufour, Philip L Cyr, Katherine A Sulham
BACKGROUND: It is estimated that acute bacterial skin and skin structure infections (ABSSSI) account for nearly 10% of hospital admissions and 3.4-3.8 million emergency department visits per year in the United States. Analyses of hospital discharge records indicate 74% of ABSSSI admissions involve empiric treatment with methicillin-resistant Staphylococcus aureus (MRSA) active antibiotics. Analysis has shown that payer costs could be reduced if moderate-to-severe ABSSSI patients were treated to a greater extent in the observational unit followed by discharge to outpatient parenteral antibiotic therapy (OPAT)...
June 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27203290/optimization-of-a-model-of-out-of-hospital-antibiotic-therapy-opat-in-a-belgian-university-hospital-resulting-in-a-proposal-for-national-implementation
#20
Tine Ravelingien, Franky Buyle, Sabine Deryckere, Erica Sermijn, Mieke Debrauwere, Katleen Verplancke, Steven Callens, Sabrina Commeyne, Christophe Pattyn, Dirk Vogelaers
OBJECTIVES: Some infections require prolonged parenteral antimicrobial therapy, which can be continued in an outpatient setting. The Ghent University Hospital has 15 years of experience with Outpatient Parenteral Antimicrobial Therapy (OPAT) in the home setting of the patient. METHODS: Multidisciplinary critical approach through identification of areas for improvement with the existing OPAT process within the Ghent University Hospital. Existing literature and guidelines were used as references...
May 19, 2016: Acta Clinica Belgica
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