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The Impact of Pediatric Outpatient Parenteral Antibiotic Therapy Implementation at a Tertiary Children’s Hospital in the United Kingdom

Patel, Sanjay, MA, MBBS*,†,‡; Burzio, Valentina, MD*; Green, Helen, RN*; Rees, Sara, RN*; Tebruegge, Marc, MD, PhD†,§,¶,‖; Jones, Christine, MD, PhD*,‡,§; Faust, Saul N., MD, PhD*,†,‡,§

The Pediatric Infectious Disease Journal: December 2018 - Volume 37 - Issue 12 - p e292–e297
doi: 10.1097/INF.0000000000002031
Antimicrobial Reports
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Background: Recent advances in outpatient parenteral antibiotic therapy (OPAT) have largely focused on adult practice, and there are few published data on the safety and effectiveness of pediatric OPAT (p-OPAT).

Methods: During a 3-year period (2012 to 2015), data were prospectively collected on patients managed within the p-OPAT service at Southampton Children’s Hospital, a tertiary pediatric hospital in the South of England.

Results: A total of 130 p-OPAT episodes were managed during this period. The most frequently managed pathologies were bone and joint infections (44.6%), followed by ear, nose and throat (10.7%), respiratory (10.0%) and central nervous system (10.0%) infections. The most frequently used antimicrobial agent was ceftriaxone (n = 103; 79.2%). For the majority of p-OPAT episodes, antimicrobials were delivered in prefilled syringes (n = 109; 83.8%); 24-hour infusions administered by elastomeric devices were used less commonly (n = 16; 12.3%). The median duration of p-OPAT treatment was 9.2 days (interquartile range: 7.6–19.0 days). With regard to patient outcomes, 113 (86.9%) p-OPAT episodes resulted in cure and 12 (9.2%) in improvement; treatment failure occurred in 5 (3.9%) episodes. Intravenous catheter–related complications were rare. A total of 1683 bed days were saved over the 3-year period.

Conclusions: Our data suggest that p-OPAT is safe and effective, with the potential to offer considerable savings for the healthcare economy through reduced length of inpatient stay.

From the *Department of Paediatric Immunology & Infectious Diseases

NIHR Biomedical Research Centre

NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom

§Faculty of Medicine and Institute for Life Sciences

Global Health Research Institute, University of Southampton, Southampton, United Kingdom

Department of Paediatric Immunology & Infectious Diseases, Evelina London Children’s Hospital, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom.

Accepted for publication February 28, 2018.

The authors have no conflicts of interest or funding to disclose.

Address for correspondence: Sanjay Patel, MA, MBBS, Department of Paediatric Immunology and Infectious diseases, Southampton Children’s Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, England. E-mail: sanjay.patel@uhs.nhs.uk

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