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The impact of Pediatric Outpatient Parenteral Antibiotic Therapy (p-OPAT) implementation at a tertiary children's hospital in the United Kingdom

The impact of Pediatric Outpatient Parenteral Antibiotic Therapy (p-OPAT) implementation at a tertiary children's hospital in the United Kingdom
The impact of Pediatric Outpatient Parenteral Antibiotic Therapy (p-OPAT) implementation at a tertiary children's hospital in the United Kingdom
Background: Recent advances in outpatient parenteral antibiotic therapy (OPAT) have largely focused on adult practice, and there are few published data on the safety and effectiveness of pediatric OPAT (p-OPAT).

Methods: During a 3-year period (2012 to 2015), data were prospectively collected on patients managed within the p-OPAT service at Southampton Children’s Hospital, a tertiary pediatric hospital in the South of England.

Results: A total of 130 p-OPAT episodes were managed during this period. The most frequently managed pathologies were bone and joint infections (44.6%), followed by ear, nose and throat (10.7%), respiratory (10.0%) and central nervous system (10.0%) infections. The most frequently used antimicrobial agent was ceftriaxone (n = 103; 79.2%). For the majority of p-OPAT episodes, antimicrobials were delivered in prefilled syringes (n = 109; 83.8%); 24-hour infusions administered by elastomeric devices were used less commonly (n = 16; 12.3%). The median duration of p-OPAT treatment was 9.2 days (interquartile range: 7.6–19.0 days). With regard to patient outcomes, 113 (86.9%) p-OPAT episodes resulted in cure and 12 (9.2%) in improvement; treatment failure occurred in 5 (3.9%) episodes. Intravenous catheter–related complications were rare. A total of 1683 bed days were saved over the 3-year period.

Conclusions: Our data suggest that p-OPAT is safe and effective, with the potential to offer considerable savings for the healthcare economy through reduced length of inpatient stay.
2048-7193
e292-e297
Patel, Sanjay
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Burzio, Valentina
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Green, Helen
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Rees, Sara
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Tebruegge, Marc
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Jones, Christine E.
48229079-8b58-4dcb-8374-d9481fe7b426
Faust, Saul N.
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Patel, Sanjay
bc976df6-0414-459f-8390-3eca85e07d97
Burzio, Valentina
08613f96-f295-46b6-9290-ebf2d85db9b5
Green, Helen
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Rees, Sara
fed1b1a6-6d68-4069-b086-017f0f94a002
Tebruegge, Marc
2c3dff22-0b5f-48a7-bb36-ce323705f74a
Jones, Christine E.
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Faust, Saul N.
f97df780-9f9b-418e-b349-7adf63e150c1

Patel, Sanjay, Burzio, Valentina, Green, Helen, Rees, Sara, Tebruegge, Marc, Jones, Christine E. and Faust, Saul N. (2018) The impact of Pediatric Outpatient Parenteral Antibiotic Therapy (p-OPAT) implementation at a tertiary children's hospital in the United Kingdom. Journal of the Pediatric Infectectious Diseases Society, 37 (12), e292-e297. (doi:10.1097/INF.0000000000002031).

Record type: Article

Abstract

Background: Recent advances in outpatient parenteral antibiotic therapy (OPAT) have largely focused on adult practice, and there are few published data on the safety and effectiveness of pediatric OPAT (p-OPAT).

Methods: During a 3-year period (2012 to 2015), data were prospectively collected on patients managed within the p-OPAT service at Southampton Children’s Hospital, a tertiary pediatric hospital in the South of England.

Results: A total of 130 p-OPAT episodes were managed during this period. The most frequently managed pathologies were bone and joint infections (44.6%), followed by ear, nose and throat (10.7%), respiratory (10.0%) and central nervous system (10.0%) infections. The most frequently used antimicrobial agent was ceftriaxone (n = 103; 79.2%). For the majority of p-OPAT episodes, antimicrobials were delivered in prefilled syringes (n = 109; 83.8%); 24-hour infusions administered by elastomeric devices were used less commonly (n = 16; 12.3%). The median duration of p-OPAT treatment was 9.2 days (interquartile range: 7.6–19.0 days). With regard to patient outcomes, 113 (86.9%) p-OPAT episodes resulted in cure and 12 (9.2%) in improvement; treatment failure occurred in 5 (3.9%) episodes. Intravenous catheter–related complications were rare. A total of 1683 bed days were saved over the 3-year period.

Conclusions: Our data suggest that p-OPAT is safe and effective, with the potential to offer considerable savings for the healthcare economy through reduced length of inpatient stay.

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P-OPAT paper - FINAL 4_12_17 - Accepted Manuscript
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Accepted/In Press date: 28 February 2018
Published date: 1 December 2018

Identifiers

Local EPrints ID: 418844
URI: http://eprints.soton.ac.uk/id/eprint/418844
ISSN: 2048-7193
PURE UUID: 30f47c8b-e7c7-4aca-adfe-86c69e59156e
ORCID for Christine E. Jones: ORCID iD orcid.org/0000-0003-1523-2368
ORCID for Saul N. Faust: ORCID iD orcid.org/0000-0003-3410-7642

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Date deposited: 23 Mar 2018 17:30
Last modified: 22 Nov 2021 06:14

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Contributors

Author: Sanjay Patel
Author: Valentina Burzio
Author: Helen Green
Author: Sara Rees
Author: Marc Tebruegge
Author: Saul N. Faust ORCID iD

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