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https://www.readbyqxmd.com/read/28638844/predictors-of-unplanned-hospitalization-in-patients-receiving-outpatient-parenteral-antimicrobial-therapy-across-a-large-integrated-healthcare-network
#1
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
#2
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
#3
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
#4
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
#5
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...
May 15, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28499957/costs-of-outpatient-parenteral-antimicrobial-therapy-opat-administered-by-hospital-at-home-units-in-spain
#6
V J González-Ramallo, M Mirón-Rubio, A Mujal, O Estrada, C Forné, B Aragón, A J Rivera
The aim of this study was to assess the direct healthcare costs of outpatient parenteral antimicrobial therapy (OPAT) administered by Hospital at Home (HaH) units in Spain. An observational, multicentre, economic evaluation of retrospective cohorts was conducted. Patients were treated at home by the HaH units of three Spanish hospitals between January 2012 and December 2013. From the cost accounting of HaH OPAT (staff, pharmacy, transportation, diagnostic tests and structural), the cost of each outpatient course was obtained following a top-down strategy based on the use of resources...
May 9, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28456704/outpatient-treatment-of-osteomyelitis-with-telavancin
#7
Claudia P Schroeder, Lucinda J Van Anglen, Robin H Dretler, John S Adams, Richard C Prokesch, Quyen Luu, Andrew H Krinsky
Telavancin is a lipoglycopeptide antibiotic with bactericidal activity against Gram-positive pathogens including Staphylococcus aureus, the most frequent cause of osteomyelitis. Treatment is often challenging due to needs for surgical intervention along with prolonged administration of intravenous antimicrobials, frequently in an outpatient setting. This was a retrospective analysis of the efficacy and safety of telavancin for treatment of osteomyelitis provided as outpatient parenteral antimicrobial therapy (OPAT) in physician office infusion centres...
July 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28437190/consuming-a-ketogenic-diet-while-receiving-radiation-and-chemotherapy-for-locally-advanced-lung-cancer-and-pancreatic-cancer-the-university-of-iowa-experience-of-two-phase-1-clinical-trials
#8
Amir Zahra, Melissa A Fath, Emyleigh Opat, Kranti A Mapuskar, Sudershan K Bhatia, Daniel C Ma, Samuel N Rodman Iii, Travis P Snyders, Catherine A Chenard, Julie M Eichenberger-Gilmore, Kellie L Bodeker, Logan Ahmann, Brian J Smith, Sandy A Vollstedt, Heather A Brown, Taher Abu Hejleh, Gerald H Clamon, Daniel J Berg, Luke I Szweda, Douglas R Spitz, John M Buatti, Bryan G Allen
Ketogenic diets are low in carbohydrates and high in fat, which forces cells to rely more heavily upon mitochondrial oxidation of fatty acids for energy. Relative to normal cells, cancer cells are believed to exist under a condition of chronic mitochondrial oxidative stress that is compensated for by increases in glucose metabolism to generate reducing equivalents. In this study we tested the hypothesis that a ketogenic diet concurrent with radiation and chemotherapy would be clinically tolerable in locally advanced non-small cell lung cancer (NSCLC) and pancreatic cancer and could potentially exploit cancer cell oxidative metabolism to improve therapeutic outcomes...
June 2017: Radiation Research
https://www.readbyqxmd.com/read/28428184/clinical-and-cost-effectiveness-safety-and-acceptability-of-community-intravenous-antibiotic-service-models-civas-systematic-review
#9
E D Mitchell, C Czoski Murray, D Meads, J Minton, J Wright, M Twiddy
OBJECTIVE: Evaluate evidence of the efficacy, safety, acceptability and cost-effectiveness of outpatient parenteral antimicrobial therapy (OPAT) models. DESIGN: A systematic review. DATA SOURCES: MEDLINE, EMBASE, CINAHL, Cochrane Library, National Health Service (NHS) Economic Evaluation Database (EED), Research Papers in Economics (RePEc), Tufts Cost-Effectiveness Analysis (CEA) Registry, Health Business Elite, Health Information Management Consortium (HMIC), Web of Science Proceedings, International Pharmaceutical Abstracts, British Society for Antimicrobial Chemotherapy website...
April 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28419343/utilizing-a-modified-care-coordination-measurement-tool-to-capture-value-for-a-pediatric-outpatient-parenteral-and-prolonged-oral-antibiotic-therapy-program
#10
Louise E Vaz, Cindi L Farnstrom, Kimberly K Felder, Judith Guzman-Cottrill, Hannah Rosenberg, Richard C Antonelli
Background.: Outpatient parenteral or prolonged oral antibiotic therapy (OPAT) programs reduce inpatient healthcare costs by shifting care to outpatient settings. Care coordination (CC) is a necessary component to successfully transition patients. Our objective was to assess outcomes of provider time spent on nonreimbursable CC activities in a pediatric OPAT program. Methods.: We used a qualitative feasibility pilot design and modified the Care Coordination Measurement Tool...
April 17, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28399052/a-comparison-of-hospital-versus-outpatient-parenteral-antibiotic-therapy-at-home-for-pyelonephritis-and-meningitis
#11
Conor C Hensey, Arun Sett, Tom G Connell, Penelope A Bryant
BACKGROUND: Despite the benefits of home treatment with outpatient parenteral antimicrobial therapy (OPAT), children with pyelonephritis and meningitis are rarely included. We aimed to compare clinical characteristics and outcomes between hospital and home treatment for these conditions, and to identify factors influencing home treatment. METHODS: Children admitted to the hospital with pyelonephritis or proven and presumed bacterial meningitis from 1/1/2012-31/12/2013 were identified retrospectively...
April 10, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28325865/venetoclax-and-obinutuzumab-in-chronic-lymphocytic-leukemia
#12
LETTER
Kirsten Fischer, Othman Al-Sawaf, Anna-Maria Fink, Mark Dixon, Jasmin Bahlo, Simon Warburton, Thomas J Kipps, Robert Weinkove, Sue Robinson, Till Seiler, Stephen Opat, Carolyn Owen, Javier López, Kathryn Humphrey, Rod Humerickhouse, Eugen Tausch, Lukas Frenzel, Barbara Eichhorst, Clemens-M Wendtner, Stephan Stilgenbauer, Anton W Langerak, Jacque J M van Dongen, Sebastian Böttcher, Matthias Ritgen, Valentin Goede, Mehrdad Mobasher, Michael Hallek
No abstract text is available yet for this article.
May 11, 2017: Blood
https://www.readbyqxmd.com/read/28283831/patient-satisfaction-in-an-outpatient-parenteral-antimicrobial-therapy-opat-unit-practising-predominantly-self-administration-of-antibiotics-with-elastomeric-pumps
#13
L Saillen, L Arensdorff, E Moulin, R Voumard, C Cochet, N Boillat-Blanco, C Gardiol, S de Vallière
Self-administration of antibiotics using elastomeric pumps has become the most frequently used treatment modality at the outpatient parenteral antimicrobial therapy (OPAT) unit of the University Hospital of Lausanne. However, it remains unknown how comfortable patients feel using this mode of treatment. A questionnaire was offered to all patients treated at the OPAT unit between June 2014 and December 2015. The questionnaire was distributed to 188 patients and 112 questionnaires were returned. Seventy-one patients were treated by self-administration, 21 attended the OPAT unit on a daily basis, and 20 received their antibiotics from home-care nurses...
March 11, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28279155/acute-dental-infections-managed-in-an-outpatient-parenteral-antibiotic-program-setting-prospective-analysis-and-public-health-implications
#14
William J Connors, Heidi H Rabie, Rafael L Figueiredo, Donna L Holton, Michael D Parkins
BACKGROUND: The number of Acute Dental Infections (ADI) presenting for emergency department (ED) care are steadily increasing. Outpatient Parenteral Antibiotic Therapy (OPAT) programs are increasingly utilized as an alternative cost-effective approach to the management of serious infectious diseases but their role in the management of severe ADI is not established. This study aims to address this knowledge gap through evaluation of ADI referrals to a regional OPAT program in a large Canadian center...
March 9, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28215410/predicting-the-risk-of-osteopenia-for-women-aged-40-55-years
#15
Jen-Hau Chen, Yen-Ching Chen, Min-Kuang Tsai, Jeng-Min Chiou, Wen-Chung Lee, Chwen-Keng Tsao, Keh-Sung Tsai, Wei-Chu Chie
BACKGROUND/PURPOSE: Osteoporosis has been linked to an increased fracture risk and subsequent mortality in the later life. Previous prediction models have focused on osteoporosis in postmenopausal women; however, a prediction tool for osteopenia is needed. Our objective was to establish a prediction model for osteopenia risk in women aged 40-55 years. METHODS: This was a cross-sectional study. A total of 1350 Taiwanese women aged 40-55 years were recruited from a health checkup center from 2009 to 2010...
February 15, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28158637/antibiotic-stability-related-to-temperature-variations-in-elastomeric-pumps-used-for-outpatient-parenteral-antimicrobial-therapy-opat
#16
Rachel Voumard, Niklas Van Neyghem, Camille Cochet, Céline Gardiol, Laurent Decosterd, Thierry Buclin, Serge de Valliere
Background: Elastomeric pumps can be used for the continuous administration of antimicrobials in the outpatient setting. A potentially limiting factor in their use is the stability of antimicrobials. Objectives: To investigate under real-life conditions the temperature variations of antibiotic solutions contained in elastomeric pumps, and to examine under such conditions the stability of five antibiotics. Methods: Healthy volunteers carried the elastomeric pumps in carry pouches during their daily activities...
May 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28132552/service-development-of-a-nurse-led-community-based-picc-insertion-service
#17
Eva Bedford, Dee Waterhouse
Patients receiving intravenous therapy require reliable venous access. Typically patients with poor peripheral access or requiring long-term treatment from an outpatient antibiotic therapy (OPAT) service need to receive secondary care input for safe central line placement, and radiological confirmation of the correct line tip placement where necessary, if treatment is to proceed as planned. Technological developments that enable accurate ultrasound-guided vein selection and electrocardiograph (ECG)-guided central line tip placement have eliminated the need for radiological or fluoroscopic confirmation of correct tip placement for peripherally placed central catheters (PICCs)...
January 26, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28110617/characterization-of-drug-related-problems-occurring-in-patients-receiving-outpatient-antimicrobial-therapy
#18
Cory M Hale, Jeffrey M Steele, Robert W Seabury, Christopher D Miller
BACKGROUND: Despite the numerous benefits of outpatient parenteral antimicrobial therapy (OPAT), appreciable risks of drug-related problems (DRPs) exist. No studies to date comprehensively assess DRPs in this population. OBJECTIVES: Objectives of this study were to (1) characterize the frequency and types of DRPs experienced by patients discharged on OPAT and (2) determine the fraction of adverse drug reactions (ADRs) resulting in hospital readmission or emergency department (ED) presentation and changes in therapy...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28077673/outpatient-parenteral-antibiotic-therapy-opat-in-asia-missing-an-opportunity
#19
Dale Fisher, Jessica Michaels, Ryota Hase, Jing Zhang, Sushila Kataria, Benedict Sim, Joseph Kay-Yan Tsang, James Pollard, Monica Chan, Subramanian Swaminathan
Objectives: Healthcare facilities internationally have grown outpatient parenteral antibiotic administration services for the last few decades. The literature contains publications from dozens of countries describing systematized processes with specialist oversight and their levels of service provision and outcomes. Such descriptions are absent in the majority of Asian countries. We sought to elucidate the extent and nature of outpatient parenteral antibiotic therapy (OPAT) in Asia and to consider the ramifications and opportunities for improvement...
April 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28073966/extended-stability-of-antimicrobial-agents-in-administration-devices
#20
Abi Jenkins, Tim Hills, Mark Santillo, Mark Gilchrist
Background: Outpatient parenteral antimicrobial therapy (OPAT) is an established approach to patient care. A lack of data on antimicrobial stability within administration devices is a barrier to service expansion, and poses an antimicrobial stewardship dilemma. Often broad-spectrum, long half-life agents are used instead of narrow-spectrum agents, which need more frequent administration, but could possibly be used if stability data were available. Objectives: To complete a comprehensive literature review of published antimicrobial stability data, and assess these against a nationally recognized minimum dataset for medicines compounded into administration devices...
April 1, 2017: Journal of Antimicrobial Chemotherapy
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