Experience of Infectious Diseases Consultants with Outpatient Parenteral Antimicrobial Therapy: Results of an Emerging Infections Network Survey

• Published in: Clinical infectious diseases 2006-11, Vol.43 (10), p.1290-1295
• Main Authors: Chary, Aarthi, Tice, Alan D., Martinelli, Lawrence P., Liedtke, Laura A., Plantenga, Melissa S., Strausbaugh, Larry J.
• Format: Article
• Language: English
• Subjects: Anti-Infective Agents - adverse effects; Anti-Infective Agents - therapeutic use; Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimicrobials; Articles and Commentaries; Biological and medical sciences; Catheters; Communicable Diseases - complications; Communicable Diseases - drug therapy; Consultants; Equipment and Supplies - adverse effects; Health Care Surveys; Home Care Services; Humans; Infections; Infectious diseases; Information Services; Infusions, Parenteral - adverse effects; Infusions, Parenteral - methods; Medical practice; Medical sciences; Medical specialists; Medical treatment; Outpatients; Pathology; Pediatrics; Pharmacology. Drug treatments; Physicians; Studies; Therapy
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/508456

Background. Despite the increasing use of outpatient parenteral antimicrobial therapy (OPAT), little is known about the role of infectious diseases consultants in the process or their perceptions of OPAT. Methods. In May 2004, the Infectious Diseases Society of America Emerging Infections Network (EIN) surveyed its members to characterize their involvement and experiences with OPAT. Results. Of the 454 respondents (54%) who completed the questionnaire, 426 (94%) indicated that patients in their primary inpatient facility were “frequently” discharged while receiving OPAT, estimating that, on average, 19 patients are discharged from their hospitals while receiving OPAT each month. Although 86% of EIN members stated that they personally order OPAT for some patients, 18% indicated that they have no involvement, and 37% stated they only rarely or occasionally oversee OPAT. EIN members involved in OPAT estimated that ∼90% of their patients who take OPAT received therapy at home, and the members described variable monitoring and oversight methods. Of the respondents, 68% of providers collectively estimated that they encountered 1951 infectious and serious noninfectious complications of OPAT in the past year. The most frequently used antibiotics included vancomycin, ceftriaxone, and cefazolin, most commonly used for bone and joint infections. Conclusions. These results testify to the pervasive use of OPAT in today's health care system, the variable role of infectious diseases consultants, and the heterogeneity in oversight and management practices. The widespread use of OPAT and its frequent complications indicate the need for additional studies to establish optimal methods of delivery and management to insure the quality and safety of the process.