Outpatient parenteral antimicrobial therapy practices among adult infectious disease physicians

Michael A. Lane, Jonas Marschall, Susan E. Beekmann, Philip M. Polgreen, Ritu Banerjee, Adam L. Hersh, Hilary M. Babcock

Research output: Contribution to journalArticle

22 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)839-844
Number of pages6
JournalInfection Control and Hospital Epidemiology
Volume35
Issue number7
DOIs
StatePublished - 2014

Fingerprint

Communicable Diseases
Outpatients
Physicians
Therapeutics
Physiologic Monitoring
Infection
Sentinel Surveillance
Surveys and Questionnaires
Vancomycin
Patient Safety
Centers for Disease Control and Prevention (U.S.)
North America
Exanthema
Inpatients
Referral and Consultation
Demography
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Microbiology (medical)
  • Epidemiology
  • Infectious Diseases
  • Medicine(all)

Cite this

Lane, M. A., Marschall, J., Beekmann, S. E., Polgreen, P. M., Banerjee, R., Hersh, A. L., & Babcock, H. M. (2014). Outpatient parenteral antimicrobial therapy practices among adult infectious disease physicians. Infection Control and Hospital Epidemiology, 35(7), 839-844. https://doi.org/10.1086/676859

Outpatient parenteral antimicrobial therapy practices among adult infectious disease physicians. / Lane, Michael A.; Marschall, Jonas; Beekmann, Susan E.; Polgreen, Philip M.; Banerjee, Ritu; Hersh, Adam L.; Babcock, Hilary M.

In: Infection Control and Hospital Epidemiology, Vol. 35, No. 7, 2014, p. 839-844.

Research output: Contribution to journalArticle

Lane, MA, Marschall, J, Beekmann, SE, Polgreen, PM, Banerjee, R, Hersh, AL & Babcock, HM 2014, 'Outpatient parenteral antimicrobial therapy practices among adult infectious disease physicians', Infection Control and Hospital Epidemiology, vol. 35, no. 7, pp. 839-844. https://doi.org/10.1086/676859
Lane, Michael A. ; Marschall, Jonas ; Beekmann, Susan E. ; Polgreen, Philip M. ; Banerjee, Ritu ; Hersh, Adam L. ; Babcock, Hilary M. / Outpatient parenteral antimicrobial therapy practices among adult infectious disease physicians. In: Infection Control and Hospital Epidemiology. 2014 ; Vol. 35, No. 7. pp. 839-844.
@article{46805bdc40074ebd83a93a2c1b0c4ac0,
title = "Outpatient parenteral antimicrobial therapy practices among adult infectious disease physicians",
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.",
author = "Lane, {Michael A.} and Jonas Marschall and Beekmann, {Susan E.} and Polgreen, {Philip M.} and Ritu Banerjee and Hersh, {Adam L.} and Babcock, {Hilary M.}",
year = "2014",
doi = "10.1086/676859",
language = "English (US)",
volume = "35",
pages = "839--844",
journal = "Infection Control and Hospital Epidemiology",
issn = "0899-823X",
publisher = "University of Chicago Press",
number = "7",

}

TY - JOUR

T1 - Outpatient parenteral antimicrobial therapy practices among adult infectious disease physicians

AU - Lane, Michael A.

AU - Marschall, Jonas

AU - Beekmann, Susan E.

AU - Polgreen, Philip M.

AU - Banerjee, Ritu

AU - Hersh, Adam L.

AU - Babcock, Hilary M.

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84902989975&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902989975&partnerID=8YFLogxK

U2 - 10.1086/676859

DO - 10.1086/676859

M3 - Article

C2 - 24915212

AN - SCOPUS:84902989975

VL - 35

SP - 839

EP - 844

JO - Infection Control and Hospital Epidemiology

JF - Infection Control and Hospital Epidemiology

SN - 0899-823X

IS - 7

ER -