Antibiotic Clinic: Two Years’ Experience in Outpatient Parenteral Antimicrobial Therapy in a Portuguese Hospital

Abstract

Introduction: Outpatient antimicrobial therapy programs have been in place for more than four decades. They provide safe and effective treatment for a selected group of patients while reducing costs. In Europe in general, and in Portugal in particular, these programs are still a relatively new phenomenon. The aim of this study is to describe our center’s two years’ experience with such a program (Antibiotic Clinic).Material and Methods: The cohort of treatments administered by the Antibiotic Clinic in its first two years of existence (September 12th 2016 to September 11th 2018) was analyzed and data pertaining to patients, infections, infectious agents, antimicrobials and outcomes (infection resolution, adverse events and death) were characterized.Results: The Antibiotic Clinic treated 231 patients in 250 episodes, providing a total of 2357 days of antibiotic treatment. The urinary tract was the most common site (39.2%) and Enterobacteriaceae the most common agents (63.7% of isolates). Infections were resolved in 90.8% of treatments (95.6% of patients), adverse events were few (1.2%) and direct mortality was not found. The dropout rate was 1.6%.Discussion: Infection resolution and adverse event rates were comparable to other centers. High treatment and low dropout rates point to high physician and patient acceptance.Conclusion: Our experience with this program suggests it is a safe and effective alternative to inpatient admission. This is in line with current literature which suggests efforts should be made to expand this treatment modality.

Outpatient parenteral antimicrobial therapy (OPAT) from an emergency model applied during the COVID-19 pandemic to standard of care: Preliminary lessons from our experience

“…They were suffering from infectious diseases other than COVID19 such as bacterial infections of the heart, bone, skin and soft tissues, the sensory organs, and the central nervous system. In order to treat patients with mild and severe infections in an emergency context of unavailability of hospital beds, our outpatient infectious disease center imported a health care model already applied in countries such as the UK, the USA, Belgium, Portugal, Netherlands, and Switzerland known as OPAT (Outpatient Parenteral Antimicrobial Therapy) [3] , [4] , [5] , [6] . There exist three main models of OPAT according to whether antibiotic therapy is administered directly at the patient’s home (either by the patient himself or by a caregiver), at a dedicated infusion center, or in nursing facilities [7] .…”