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Outpatient parenteral antimicrobial therapy (OPAT) practices among adult infectious disease physicians
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May 09 2014
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Source: Infect Control Hosp Epidemiol. 35(7):839-844.
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Details:
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Alternative Title:Infect Control Hosp Epidemiol
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Description:Objective
To identify current outpatient parenteral antibiotic therapy practice patterns and complications.
Methods
We administered an 11 question survey to adult infectious disease physicians participating in the Emerging Infections Network (EIN), a CDC-sponsored sentinel event surveillance network in North America. The survey was distributed electronically or via facsimile in November and December 2012. Respondent demographic characteristics were obtained from EIN enrollment data.
Results
Overall, 555 (44.6%) of EIN members responded to the survey with 450 (81%) indicating they treated ≥ 1 patient with OPAT during an average month. ID consultation was reported to be required for a patient to be discharged on OPAT by 99 (22%) respondents. Inpatient (282/449; 63%) and outpatient (232/449; 52%) ID physicians were frequently identified as being responsible for monitoring lab results. Only 26% (118/448) had dedicated OPAT teams at their clinical site. Few ID physicians have systems to track errors, adverse events or “near-misses” associated with OPAT (97/449; 22%). OPAT complications were perceived to be rare. Among respondents, 80% reported line occlusion/clotting as the most common complication (occurring in ≥6% of patients), followed by nephrotoxicity and rash (each reported by 61%). Weekly lab monitoring of patients on vancomycin was reported by 77% (343/445) of respondents; whereas 19% (84/445) of respondents reported twice weekly lab monitoring for these patients.
Conclusions
Although utilization of OPAT is common, there is significant variation in practice patterns. More uniform OPAT practices may enhance patient safety.
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Pubmed ID:24915212
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Pubmed Central ID:PMC4180108
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