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Review of the first comprehensive outpatient parenteral antimicrobial therapy program in a tertiary care hospital in Japan
Journal article   Open access   Peer reviewed

Review of the first comprehensive outpatient parenteral antimicrobial therapy program in a tertiary care hospital in Japan

Ryota Hase, Yoshiaki Yokoyama, Hiroyuki Suzuki, Shunsuke Uno, Takahiro Mikawa, Daisuke Suzuki, Kiyoharu Muranaka and Naoto Hosokawa
International journal of infectious diseases, Vol.95, pp.210-215
06/2020
DOI: 10.1016/j.ijid.2020.03.033
PMID: 32205285
url
https://doi.org/10.1016/j.ijid.2020.03.033View
Published (Version of record) Open Access

Abstract

•Outpatient parenteral antimicrobial therapy (OPAT) is not widely recognized in Japan.•The infectious diseases team at a general hospital in Japan implemented a new OPAT program in 2012 and treated 66 patients for 5.5 years.•This study is the first English description of a comprehensive OPAT program in Japan.•OPAT is a safe and feasible practice not only for efficient bed utilization and medical cost savings but also for better antimicrobial stewardship.•Many barriers, such as financial disincentives or drug administration-related issues in the healthcare insurance system, negatively impact the expansion of OPAT practice in Japan. The infectious diseases team at Kameda Medical Center, Japan, implemented a new outpatient parenteral antimicrobial therapy (OPAT) program in July 2012 and expanded the program with the support of home care services. This study reviews the OPAT program after 5.5 years of operation. We prospectively collected data about the age, sex, diagnoses, causative organisms, types of OPAT, modes of administration, selected antibiotics, treatment durations, bed days saved, outcomes, readmissions, and estimated cost reductions of all patients who were treated in the OPAT program from July 2012 to December 2017. Of the 66 patients treated under the OPAT program, 45 (68.2%) were treated using clinic OPAT, and 21 (31.8%) were treated using homecare OPAT. The most commonly targeted organism was methicillin-susceptible Staphylococcus aureus. Continuous infusion with elastomeric pumps was employed in 55 patients (83.3%). Cefazolin was the most frequently used antibiotic (39.4%), followed by penicillin G (24.2%). The median OPAT duration was 13 days (range, 3–51), and the total bed days saved was 923. The estimated medical cost reduction was approximately 87,000 US dollars. Our experience shows that OPAT is a safe and feasible practice not only for efficient bed utilization and medical cost savings but also for better antimicrobial stewardship.
 Antimicrobial stewardship Bed days saved Outpatient parenteral antimicrobial therapy

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