Outcomes and Pharmacoeconomic Analysis of a Home Intravenous Antibiotic Infusion Program in Veterans

Safety and effectiveness of ‘hospital in the home’ and ‘outpatient parenteral antimicrobial therapy’ in different age groups: A systematic review of observational studies

“…Twenty‐six studies published between 1997 and 2016 analysed the safety and effectiveness of OPAT services. This included 3 prospective studies without comparison group and 23 retrospective studies without comparison group . Nine studies were performed in Europe, eight in the USA, two in Australia, two in New Zealand, two in Singapore, one in Canada, one in Saudi Arabia and one in Israel .…”

“…Most of the OPAT studies reported a cure or treatment success rate of greater than 80%, readmission rate ranged from 1% to 14.3%, mortality rate varied from 0% to 1.4%, VAD related complications ranged from 0% to 25% and adverse drug reactions rate varied from 0.3% to 30.2% . A few studies reported more complications and adverse events compared with the other studies and recommended that close monitoring is needed in OPAT service and that OPAT programs should be tailored for each disease…”

“…Numerous studies assessing the adverse events (AEs) and effectiveness of HITH and OPAT have been performed in many countries including Australia, USA, UK, Spain, France, Singapore, Israel, Canada, Italy, Ireland, New Zealand, Saudi Arabia, Switzerland and Greece . Some studies have analysed the safety of HITH or OPAT for a particular disease or for a particular group including geriatric or paediatric patients …”

Risk Factors Associated With Outpatient Parenteral Antibiotic Therapy Program Failure Among Intravenous Drug Users

“…The higher failure rates reported here attest to the complex nature of treating IVDUs receiving OPAT, who tend to have severe, life-threatening infections such as endocarditis. In contrast, OPAT clinical failures are rare among general, non-IVDU populations [10], who have various infections but tend to be older with more comorbid conditions. The disproportionately high rate of clinical failure among IVDUs is compounded by a high rate of ADRs.…”

“…Where clinically appropriate, the cephalosporins may be more amenable to OPAT given their excellent tolerability [13]. This is particularly important for IVDUs because our overall rate of ADRs appears to be higher than ADR rates reported among other patient populations [10]. It is not immediately apparent why ADR rates are higher among IVDUs; however, future investigations are warranted to identify socioeconomic and clinical factors that may contribute to this disparity.…”