Outpatient parenteral antibiotic therapy (OPAT) for bone and joint infections: experience from a UK teaching hospital-based service

Abstract

For the majority of conditions, BJI can be successfully managed through OPAT. Identification of those likely to respond less well, including older patients, those with DFI and those with infections by resistant organisms, may encourage enhanced vigilance and consideration of newer or more aggressive treatments in these subgroups of patients.

Outpatient parenteral antimicrobial therapy (OPAT) in a teaching hospital-based practice: a retrospective cohort study describing experience and evolution over 10 years

“…Whilst many previous OPAT studies, including our own [19,21,22], have been small or focused on infection-specific topics, this cohort shows that a large range of conditions as well as a complex, diverse patient group can be managed in an OPAT setting. With some exceptions [8], most OPAT studies have collected data over a time period of <3 years.…”

The Community IntraVenous Antibiotic Study (CIVAS): a mixed-methods evaluation of patient preferences for and cost-effectiveness of different service models for delivering outpatient parenteral antimicrobial therapy

“…3,13,75 Over the past 10 years, OPAT services have become more common in response to pressure for health care to be delivered in the community rather than hospital, as well as opportunities for cost savings by reducing bed occupancy. 94 However, OPAT coverage has remained patchy, with marked heterogeneity in providers, models of care and clinical services.…”

Use of Erythrocyte Sedimentation Rate and C-Reactive Protein to Predict Osteomyelitis Recurrence

“…14 Bone and joint infection with methicillin-resistant S aureus is reported to be associated with failure of initial prescription of outpatient parenteral antibiotic therapy (OR=3.3, 95% CI=1.2-9.5, p=0.03) and failure of initial therapy defined as recurrence or death after a median of 60 weeks (HR=2.2, 95% CI=1.1-3.3, p=0.009). 15 Prosthesis-related osteomyelitis is difficult to treat, owing to adherence of bacteria to biomaterials and tissues within biofilms. 16 ESR and CRP are effective in determining the presence of peri-prosthetic infection; using both can reduce the chance of false-negative results.…”