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Outpatient parenteral antimicrobial therapy (OPAT) has evolved relatively slowly in the UK. This study describes the OPAT service based in a large UK teaching hospital in Sheffield, and examines the clinical efficacy, patient acceptability and costs saved over a 10-year period. Data on 3812 episodes of OPAT administered between January 2006 and January 2016 were retrieved from a prospectively maintained electronic database. This study compared the real costs of the OPAT service with estimated costs of conventional inpatient care for these patient episodes, and analysed patient feedback questionnaires that were administered randomly between January 2014 and January 2015. A wide range of infections were managed during the 10-year period. Skin and soft tissue infections accounted for 57% of OPAT episodes. The total number of bed-days saved was 49,854. A successful outcome (cure or improvement) was found in 3357 (88%) episodes. Re-admission occurred in 265 (7%) episodes. The rates of healthcare-associated infections were low: 15 intravenous-line-related infections were recorded (0.3 per 1000 OPAT patient-days). Patient acceptance and satisfaction with OPAT were high. OPAT cost 15%, 39%, 40% and 44% of inpatient costs for an infectious diseases unit, national average costs, other departments (non-infectious diseases unit), and the minimum national average costs for each diagnostic category, respectively. This study shows that OPAT is safe, clinically efficacious and acceptable for treating a wide range of infections with high levels of patient satisfaction and substantial cost savings.

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0000-0002-9526-3852, Johnston, P. et al. (3 more authors) (2018) Developing a risk prediction model for 30-Day unplanned hospitalisation in patients receiving outpatient parenteral antimicrobial therapy. Clinical Microbiology and Infection.

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Background: Globally, the spread of HIV/AIDS remains on the rise with young people at increased risk of infection. Sexual behavior change remains the most effective way of preventing further transmission. Aim: To gain the knowledge needed to develop appropriate interventions that will enable young people to adopt safe sexual practices. Materials and Methods: A cross-sectional study was conducted using structured questionnaires among 315 randomly selected students enrolled at a tertiary institution in Lagos State, Nigeria. Results: The mean age of the respondents was 23 years. Although the mean score of the participants' responses to ten HIV/AIDS knowledge questions was 8.3 of 10 points, 73.5% of them did not perceive themselves at risk of being infected. Majority (53.8%) had not changed their dating behaviors as a result of concerns for HIV/ AIDS and 70.3% had multiple lifetime sexual partners. Those who perceived themselves at risk of infection are significantly (P = 0.019) more likely to always use condoms. Using the AIDS Risk Reduction Model (ARRM), it was found that the students are in the first stage of behavior change process: recognition of the problem. The low risk perception has prevented movement to the second stage of making commitment to change behavior. Conclusion: The awareness and knowledge of HIV/AIDS is high among tertiary education students in Lagos, Nigeria. However, risk perception is low with high-risk sexual behaviors. The failure to perceive HIV/AIDS as a personal risk has prevented commitment to behavior change. Interventions aimed at influencing risk perception are paramount to curb the spread of this dreaded disease. Optimized content for mobile and hand-held devicesHTML pages have been optimized of mobile and other hand-held devices (such as iPad, Kindle, iPod) for faster browsing speed. Click on [Mobile Full text] from Table of Contents page. This is simple HTML version for faster download on mobiles (if viewed on desktop, it will be automatically redirected to full HTML version)

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