Characteristics and outcomes of outpatient parenteral antimicrobial therapy at an academic Children's hospital

Theresa Madigan, Ritu Banerjee

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Background: Use of outpatient parenteral antimicrobial therapy (OPAT) in pediatrics is widespread and may be increasing. Recent data quantifying use and characteristics of pediatric OPAT are lacking. Methods: To evaluate the number of children receiving OPAT each year and their associated characteristics and outcomes, we conducted a retrospective review of all patients discharged with OPAT from the Mayo Clinic Children's Hospital between August 1, 2010 and December 31, 2011. Results: During the study period, there were 126 pediatric hospital discharges with OPAT (2.5% of all discharges). OPAT was used most commonly to treat bone and joint (21%), bloodstream (15%), intra-abdominal (13%) and soft tissue (9%) infections. A positive culture or serology result was found in 86 (68%) OPAT courses. The most frequently used antibiotics were ceftriaxone (17%), cefazolin (16%) and cefepime (13%). The median duration of OPAT was 12 days. Thirty-six courses (29%) resulted in catheter- or antibiotic-associated complications. Weekly laboratory monitoring was more common when OPAT was managed by the infectious disease service (88%) versus other services (20%). Among 123 courses with follow-up, 109 (89%) resulted in cure, and 13(11%) were treatment failures. Conclusion: At our children's hospital, 2.5% of hospitalized patients were discharged with OPAT. In one-third of OPAT courses children developed catheter- or antibiotic-associated complications. Opportunities to increase the role of pediatric infectious disease in OPAT initiation and management should be explored.

Original languageEnglish (US)
Pages (from-to)346-349
Number of pages4
JournalPediatric Infectious Disease Journal
Volume32
Issue number4
DOIs
StatePublished - 2013

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Keywords

  • Antimicrobial stewardship
  • Outpatient parenteral antimicrobial therapy
  • Pediatric infections
  • Peripherally inserted central catheters

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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