Journal article
Outpatient Parenteral Antimicrobial Therapy Practices among Adult Infectious Disease Physicians
Infection control and hospital epidemiology, Vol.35(7), pp.839-844
07/01/2014
DOI: 10.1086/676859
PMCID: PMC4180108
PMID: 24915212
Abstract
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 Centers for Disease Control and Prevention-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 that they treated 1 or more patients with outpatient parenteral antimicrobial therapy (OPAT) during an average month. Infectious diseases consultation was reported to be required for a patient to be discharged with OPAT by 99 respondents (22%). Inpatient (282 [63%] of 449) and outpatient (232 [52%] of 449) infectious diseases physicians were frequently identified as being responsible for monitoring laboratory results. Only 26% (118 of 448) had dedicated OPAT teams at their clinical site. Few infectious diseases physicians have systems to track errors, adverse events, or "near misses" associated with OPAT (97 [22%] of 449). OPAT-associated complications were perceived to be rare. Among respondents, 80% reported line occlusion or clotting as the most common complication (occurring in 6% of patients or more), followed by nephrotoxicity and rash (each reported by 61%). Weekly laboratory monitoring of patients who received vancomycin was reported by 77% of respondents (343 of 445), whereas 19% of respondents (84 of 445) reported twice weekly laboratory monitoring for these patients.
CONCLUSIONS. Although use of OPAT is common, there is significant variation in practice patterns. More uniform OPAT practices may enhance patient safety.
Details
- Title: Subtitle
- Outpatient Parenteral Antimicrobial Therapy Practices among Adult Infectious Disease Physicians
- Creators
- Michael A. Lane - Washington University in St. LouisJonas Marschall - Washington University in St. LouisSusan E. Beekmann - University of IowaPhilip M. Polgreen - University of IowaRitu Banerjee - Mayo Clinic in FloridaAdam L. Hersh - University of UtahHilary M. Babcock - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.35(7), pp.839-844
- DOI
- 10.1086/676859
- PMID
- 24915212
- PMCID
- PMC4180108
- NLM abbreviation
- Infect Control Hosp Epidemiol
- ISSN
- 0899-823X
- eISSN
- 1559-6834
- Publisher
- Cambridge Univ Press
- Number of pages
- 6
- Grant note
- KM1CA156708 / NATIONAL CANCER INSTITUTE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) UL1 TR000448; KL2 TR000450 / Washington University Institute of Clinical and Translational Sciences (ICTS) from the National Center for Advancing Translational Sciences Barnes-Jewish Hospital Patient Safety and Quality Fellowship Program Barnes-Jewish Hospital Foundation KL2RR024994 / NATIONAL CENTER FOR RESEARCH RESOURCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) KM1CA156708 / KM1 Scholars Program through the National Cancer Institute (NCI) at the National Institutes of Health (NIH) UL1RR024992; KL2RR024994 / NIH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA CU54 CK 000162 / Centers for Disease Control and Prevention Epicenters Program; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA KL2TR000136 / NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) 1U50CK000187 / Centers for Disease Control and Prevention; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA K12HD001459 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) 5K12HD001459-13 / Building Interdisciplinary Careers in Women's Health KL2 career development award Washington University's ICTS
- Language
- English
- Date published
- 07/01/2014
- Academic Unit
- Infectious Diseases; Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984359816402771
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