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https://www.readbyqxmd.com/read/29020202/rates-of-and-risk-factors-for-adverse-drug-events-in-outpatient-parenteral-antimicrobial-therapy
#1
Sara C Keller, Deborah Williams, Mitra Gavgani, David Hirsch, John Adamovich, Dawn Hohl, Ayse P Gurses, Sara E Cosgrove
Background: To better monitor patients on outpatient parenteral antimicrobial therapy (OPAT), we need an improved understanding of risk factors for and timing of OPAT-associated adverse drug events (ADEs). Methods: We undertook an analysis of a prospective cohort of patients discharged from two academic medical centers on OPAT. Patients underwent chart abstraction and a telephone survey. Multivariable analyses estimated adjusted incident rate ratios (aIRR) between clinical and demographic risk factors and clinician-determined clinically significant ADEs...
August 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28981573/opats-omnibus-p-value-association-tests
#2
Chia-Wei Chen, Hsin-Chou Yang
Combining statistical significances (P-values) from a set of single-locus association tests in genome-wide association studies is a proof-of-principle method for identifying disease-associated genomic segments, functional genes and biological pathways. We review P-value combinations for genome-wide association studies and introduce an integrated analysis tool, Omnibus P-value Association Tests (OPATs), which provides popular analysis methods of P-value combinations. The software OPATs programmed in R and R graphical user interface features a user-friendly interface...
July 10, 2017: Briefings in Bioinformatics
https://www.readbyqxmd.com/read/28976863/obinutuzumab-for-the-first-line-treatment-of-follicular-lymphoma
#3
Robert Marcus, Andrew Davies, Kiyoshi Ando, Wolfram Klapper, Stephen Opat, Carolyn Owen, Elizabeth Phillips, Randeep Sangha, Rudolf Schlag, John F Seymour, William Townsend, Marek Trněný, Michael Wenger, Günter Fingerle-Rowson, Kaspar Rufibach, Tom Moore, Michael Herold, Wolfgang Hiddemann
BACKGROUND: Rituximab-based immunochemotherapy has improved outcomes in patients with follicular lymphoma. Obinutuzumab is a glycoengineered type II anti-CD20 monoclonal antibody. We compared rituximab-based chemotherapy with obinutuzumab-based chemotherapy in patients with previously untreated advanced-stage follicular lymphoma. METHODS: We randomly assigned patients to undergo induction treatment with obinutuzumab-based chemotherapy or rituximab-based chemotherapy...
October 5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28949430/effectiveness-and-safety-of-outpatient-parenteral-antimicrobial-therapy-in-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#4
Miguel A Ponce González, Manuel Mirón Rubio, Abel Mujal Martinez, Oriol Estrada Cuxart, Dolores Fiuza Perez, Liliana Salas Reinoso, Estrella Fernández Fabrellas, Eusebi Chiner Vives
AIM: We analysed the effectiveness and safety of outpatient parenteral antibiotic therapy (OPAT) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in patients admitted to home hospitalisation units (HHU). METHODS: Retrospective multicentre study of patients with AECOPD included in the Spanish OPAT Registry during 2 years period. RESULTS: Twenty-seven hospitals included 562 episodes in 361 patients diagnosed COPD GOLD III-IV...
September 26, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28885476/determining-the-risk-of-sepsis-using-nurse-compounded-elastomeric-pumps-for-continuous-infusion-in-outpatient-parenteral-antibiotic-therapy
#5
Pauline M Dobson, Mark Loewenthal, Lisa Harris
Limited availability of compounded antibiotics used for continuous infusion outpatient parenteral antibiotic therapy (OPAT) can delay or interrupt an OPAT course. To solve this problem, OPAT nurses at a hospital in Australia have been compounding elastomeric pumps for immediate use. The incidence of sepsis in 5014 patients before and after the introduction of nurse compounding was compared. There were no cases of laboratory-confirmed bloodstream infection among the nurse-compounded group compared with 2 cases (0...
September 2017: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/28874503/risk-factors-for-amendment-in-type-duration-and-setting-of-prescribed-outpatient-parenteral-antimicrobial-therapy-opat-for-adult-patients-with-cellulitis-a-retrospective-cohort-study-and-cart-analysis
#6
Michael Quirke, Emma May Curran, Patrick O'Kelly, Ruth Moran, Eimear Daly, Seamus Aylward, Gerry McElvaney, Abel Wakai
PURPOSE OF THE STUDY: To measure the percentage rate and risk factors for amendment in the type, duration and setting of outpatient parenteral antimicrobial therapy (OPAT) for the treatment of cellulitis. STUDY DESIGN: A retrospective cohort study of adult patients receiving OPAT for cellulitis was performed. Treatment amendment (TA) was defined as hospital admission or change in antibiotic therapy in order to achieve clinical response. Multivariable logistic regression (MVLR) and classification and regression tree (CART) analysis were performed...
September 5, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28852672/bundle-in-the-bronx-impact-of-a-transition-of-care-outpatient-parenteral-antibiotic-therapy-bundle-on-all-cause-30-day-hospital-readmissions
#7
Theresa Madaline, Priya Nori, Wenzhu Mowrey, Elisabeth Zukowski, Shruti Gohil, Uzma Sarwar, Gregory Weston, Riganni Urrely, Matthew Palombelli, Vinnie Frank Pierino, Vanessa Parsons, Amy Ehrlich, Belinda Ostrowsky, Marilou Corpuz, Liise-Anne Pirofski
BACKGROUND: A streamlined transition from inpatient to outpatient care can decrease 30-day readmissions. Outpatient parenteral antibiotic therapy (OPAT) programs have not reduced readmissions; an OPAT bundle has been suggested to improve outcomes. We implemented a transition-of-care (TOC) OPAT bundle and assessed the effects on all-cause, 30-day hospital readmission. METHODS: Retrospectively, patients receiving postdischarge intravenous antibiotics were evaluated before and after implementation of a TOC-OPAT program in Bronx, New York, between July, 2015 and February, 2016...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28776441/economic-evaluation-of-outpatient-parenteral-antimicrobial-therapy-a-systematic-review
#8
REVIEW
Eliane Molina Psaltikidis, Everton Nunes da Silva, Joaquim Murray Bustorff-Silva, Maria Luiza Moretti, Mariângela Ribeiro Resende
Outpatient parenteral antimicrobial therapy (OPAT) consists of providing antimicrobial therapy by parenteral infusion without hospitalization. A systematic review was performed to compare OPAT and hospitalization as health care modalities from an economic perspective. Areas covered: We identified 1455 articles using 13 electronic databases and manual searches. Two independent reviewers identified 35 studies conducted between 1978 and 2016. We observed high heterogeneity in the following: countries, infection site, OPAT strategies and outcomes analyzed...
August 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28763427/safety-of-outpatient-parenteral-antimicrobial-therapy-in-children
#9
Priyanka Fernandes, Carly Milliren, Helen M Mahoney-West, Laura Schwartz, Catherine S Lachenauer, Mari M Nakamura
BACKGROUND AND OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) provides numerous benefits but may pose unique risks in children. We aimed to determine rates of OPAT antimicrobial- and intravenous-access-related complications and their associations with specific antimicrobials and type of intravenous access in pediatric patients. METHODS: Observational cohort study of patients receiving OPAT from 8/2008 to 5/2015 cared for by the Infectious Diseases service at a tertiary children's hospital...
July 31, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28711455/recommendations-for-outpatient-parenteral-antimicrobial-therapy-in-brazil
#10
REVIEW
Priscila R Oliveira, Vladimir C Carvalho, Sergio Cimerman, Ana Lucia Munhoz Lima
A panel of national experts was convened by the Brazilian Infectious Diseases Society in order to determine the recommendations for outpatient parenteral antimicrobial therapy (OPAT) in Brazil. The following aspects are covered in the document: organization of OPAT programs; patient evaluation and eligibility criteria, including clinical and sociocultural factors; diagnosis of eligibility; venous access and antimicrobial infusion devices; protocols for antimicrobial use and monitoring and cost-effectiveness...
July 13, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28697159/outpatient-parenteral-antimicrobial-therapy-and-judicious-use-of-pediatric-emergency-resources
#11
Michael Xu, Quynh Doan
BACKGROUND: Pediatric returns to the emergency department (RTED) vary between 3% and 13% of the total ED volume of visits. However, the incidence and contribution of scheduled RTED on pediatric emergency department (PED) utilization is less clear. Antimicrobial stewardship programs on inpatient wards have been shown to improve judicious use of outpatient parenteral antimicrobial therapy (OPAT) in upon discharge. The implementation of such programs in PEDs has yet to be reported. The objectives of this study are to quantify the burden of scheduled RTED for OPAT on PED utilization and to examine how frequently OPAT use are supported by published practice standards for 3 common pediatric infections-cellulitis, pneumonia, and urinary tract infections...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28685928/management-of-patients-with-previously-untreated-chronic-lymphocytic-leukaemia-with-obinutuzumab-and-chlorambucil
#12
REVIEW
Constantine Tam, Bryone Kuss, Stephen Opat, Joy Boulos, Paula Marlton
Patients with chronic lymphocytic leukaemia (CLL) are generally older, with many considered 'unfit' for fludarabine-cyclophosphamide-rituximab therapy. In these patients, the combination of obinutuzumab-chlorambucil may be an appropriate therapeutic choice. Obinutuzumab-chlorambucil has been demonstrated to improve overall survival rates compared to chlorambucil alone and to improve progression-free survival and overall response rates compared to rituximab-chlorambucil. This combination can lead to certain toxicities that need to be addressed through appropriate patient selection, pre-medication and management...
July 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28680904/risk-factors-associated-with-outpatient-parenteral-antibiotic-therapy-program-failure-among-intravenous-drug-users
#13
Deanna J Buehrle, Ryan K Shields, Neel Shah, Christopher Shoff, Kathleen Sheridan
Sixty-one percent of intravenous drug users (IVDUs) who received outpatient parenteral antibiotic therapy (OPAT) failed treatment. Hospital readmission and adverse drug reactions occurred in 25%. By multivariate analysis, time since last IVDU was associated with failure (P = .04). Intravenous drug users requiring OPAT are at high risk for failure; additional studies are needed to explore alternatives.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28673610/clinical-efficacy-cost-analysis-and-patient-acceptability-of-outpatient-parenteral-antibiotic-therapy-opat-a-decade-of-sheffield-uk-opat-service
#14
Oyewole Christopher Durojaiye, Helen Bell, Dawn Andrews, Fotinie Ntziora, Katharine Cartwright
Outpatient parenteral antimicrobial therapy (OPAT) has evolved relatively slowly in the UK. This study describes the OPAT service based in a large UK teaching hospital in Sheffield, and examines the clinical efficacy, patient acceptability and costs saved over a 10-year period. Data on 3812 episodes of OPAT treatment administered between January 2006 and January 2016 were retrieved from a prospectively maintained electronic database. This study compared the real costs of the OPAT service with estimated costs of conventional inpatient care for these patient episodes, and analysed patient feedback questionnaires that were administered randomly between January 2014 and January 2015...
June 30, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28667319/infection-is-an-independent-predictor-of-death-in-diffuse-large-b-cell-lymphoma
#15
Claire Dendle, Michael Gilbertson, Tim Spelman, Rhonda L Stuart, Tony M Korman, Karin Thursky, Stephen Opat, Zoe McQuilten
To identify risk factors for infection in patients with diffuse large B cell lymphoma (DLBCL) undergoing rituximab, cyclophosphamide, vincristine, adriamycin and prednisolone (R-CHOP) treatment. All patients with DLBCL who received R-CHOP from 2004-2014 in a tertiary Australian hospital were identified and information collected from hospital admission data, laboratory results and medical record review. Infection was defined as hospitalisation with an ICD-10-AM diagnostic code for infection. Risk factors for infection and association between infection and survival were modelled using Cox proportional hazards regression...
June 30, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28638844/predictors-of-unplanned-hospitalization-in-patients-receiving-outpatient-parenteral-antimicrobial-therapy-across-a-large-integrated-healthcare-network
#16
Monica Schmidt, Bevin Hearn, Michael Gabriel, Melanie D Spencer, Lewis McCurdy
BACKGROUND: Outpatient parenteral antimicrobial therapy (OPAT) prescribing has increased along with the trend toward early discharge of hospitalized patients who have infections. There is limited literature that assesses unplanned hospitalizations during OPAT. This study aims to elucidate the predictors of unplanned hospitalization in OPAT patients after discharge from acute-care facilities within Carolinas HealthCare System (CHS). Understanding these predictors may inform future interventions to improve treatment efficacy and patient outcomes...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28633101/assessment-of-environmental-and-health-risks-in-former-polymetallic-ore-mining-and-smelting-area-slovakia-spatial-distribution-and-accumulation-of-mercury-in-four-different-ecosystems
#17
Július Árvay, Lenka Demková, Martin Hauptvogl, Miloslav Michalko, Daniel Bajčan, Radovan Stanovič, Ján Tomáš, Miroslava Hrstková, Pavol Trebichalský
Former long-term mining and smelting of pollymetallic ores in the Middle Spiš area caused a serious contamination problem of the environment with heavy metals and metalloids, especially mercury (Hg). Several studies have reported concentration of Hg in the area but this paper provides first detailed characterization of Hg contamination of different environmental components in agricultural, forest, grassland and urban ecosystems. The ecosystems are in different distances from emission sources - former mercury and copper smelting plants in NE Slovakia...
June 17, 2017: Ecotoxicology and Environmental Safety
https://www.readbyqxmd.com/read/28585797/outpatient-parenteral-antimicrobial-therapy-for-infective-endocarditis-in-patients-over-80-years
#18
X Kortajarena, M A Goenaga, M Ibarguren, H Azkune, M J Bustinduy, A Fuertes, O Ibarguren, M Goyeneche, M Garcia
OBJECTIVE: The incidence of infective endocarditis is progressively increasing, especially in elderly patients. Outpatient parenteral antibiotic therapy (OPAT) is being an excellent alternative for treatment, but advanced age is one of the relative contraindications. The aim of this study is to compare the characteristics and prognosis of patients less or more than 80 years, treated with OPAT. METHODS: One hundred and ninety four patients were included between 1996 and 2015, 31 of them older than 80 years...
June 6, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28549165/impact-of-antimicrobial-stewardship-for-pediatric-outpatient-parenteral-antibiotic-therapy
#19
Adam L Hersh, Jared Olson, Chris Stockmann, Emily A Thorell, Elizabeth D Knackstedt, Lawanda Esquibel, Susan Sanderson, Andrew T Pavia
We developed an outpatient parenteral antibiotic therapy (OPAT) stewardship program in a freestanding children's hospital to improve the appropriateness of OPAT prescribing. Introduction of the program enabled expert review of nearly 90% of the patients being prepared for discharge with OPAT and was associated with a 24% reduction in OPAT use.
May 26, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28505278/cost-effectiveness-of-outpatient-parenteral-antibiotic-therapy-a-simulation-modelling-approach
#20
A Vargas-Palacios, D M Meads, M Twiddy, C Czoski Murray, C Hulme, E D Mitchell, A Gregson, P Stanley, J Minton
Objectives: In the UK, patients who require intravenous antimicrobial (IVA) treatment may receive this in the community through outpatient parenteral antimicrobial therapy (OPAT) services. Services include: IVA administration at a hospital outpatient clinic (HO); IVA administration at home by a general nurse (GN) or a specialist nurse (SN); or patient self-administered (SA) IVA administration following training. There is uncertainty regarding which OPAT services represent value for money; this study aimed to estimate their cost-effectiveness...
August 1, 2017: Journal of Antimicrobial Chemotherapy
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