Comparative outcomes of β-lactam antibiotics in outpatient parenteral antibiotic therapy: treatment success, readmissions and antibiotic switches

• Published in: Journal of antimicrobial chemotherapy 2015-08, Vol.70 (8), p.2389-2396
• Main Authors: Lee, Boeun, Tam, Idy, Weigel, 4th, Bernard, Breeze, Janis L, Paulus, Jessica K, Nelson, Jason, Allison, Genève M
• Format: Article
• Language: English
• Subjects: Administration, Intravenous; Adult; Aged; Ambulatory Care - methods; Anti-Bacterial Agents - adverse effects; Anti-Bacterial Agents - therapeutic use; beta-Lactams - adverse effects; beta-Lactams - therapeutic use; Drug-Related Side Effects and Adverse Reactions - epidemiology; Female; Humans; Male; Middle Aged; Original Research; Retrospective Studies; Treatment Outcome
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkv130

β-Lactam antibiotics are commonly used in outpatient parenteral antimicrobial therapy (OPAT), but data regarding outcomes of long-term therapy are limited. The purpose of this study was to compare treatment success, readmission and antibiotic switch rates in patients treated with β-lactam antibiotics as OPAT. We carried out a retrospective review of all patients, discharged from Tufts Medical Center with cefazolin, ceftriaxone, ertapenem or oxacillin, between January 2009 and June 2013. A competing risks analysis was used to compare the cumulative incidence of first occurrence of treatment success, antibiotic switch and 30 day readmission for each drug. Four hundred patients were identified (cefazolin n = 38, ceftriaxone n = 104, ertapenem n = 128 and oxacillin n = 130). Baseline demographics were similar. Treatment success rates were higher for ceftriaxone and ertapenem (cefazolin 61%, ceftriaxone 81%, ertapenem 73% and oxacillin 58%; P