Outpatient Parenteral Therapy for Complicated Staphylococcus aureus Infections: A snapshot of processes and outcomes in the real world

Jennifer Townsend, Sara Keller, Martin Tibuakuu, Sameer Thakker, Bailey Webster, Maya Siegel, Kevin J. Psoter, Omar Mansour, Trish Perl

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: In the United States, patients discharged on outpatient parenteral antimicrobial therapy (OPAT) are often treated by home health companies (HHCs) or skilled nursing facilities (SNFs). Little is known about differences in processes and outcomes between these sites of care. Methods: We performed a retrospective study of 107 patients with complicated Staphylococcus aureus infections discharged on OPAT from 2 academic medical centers. Clinical characteristics, site of posthospital care, process measures (lab test monitoring, clinic follow-up), adverse events (adverse drug events, Clostridium difficile infection, line events), and clinical outcomes at 90 days (cure, relapse, hospital readmission) were collected. Comparisons between HHCs and SNFs were conducted. Results: Overall, 33% of patients experienced an adverse event during OPAT, and 64% were readmitted at 90 days. Labs were received for 44% of patients in SNFs and 56% of patients in HHCs. At 90 days after discharge, a higher proportion of patients discharged to an SNF were lost to follow-up (17% vs 3%; P = .03) and had line-related adverse events (18% vs 2%; P < .01). Patients discharged to both sites of care experienced similar clinical outcomes, with favorable outcomes occurring in 61% of SNF patients and 70% of HHC patients at 90 days. There were no differences in rates of relapse, readmission, or mortality. Conclusions: Patients discharged to SNFs may be at higher risk for line events than patients discharged to HHCs. Efforts should be made to strengthen basic OPAT processes, such as lab monitoring and clinic follow-up, at both sites of care.

Original languageEnglish (US)
JournalOpen Forum Infectious Diseases
Volume5
Issue number11
DOIs
StatePublished - Jan 1 2018

Fingerprint

Staphylococcus aureus
Outpatients
Skilled Nursing Facilities
Infection
Therapeutics
Health
Clostridium Infections
Recurrence
Patient Readmission
Process Assessment (Health Care)
Clostridium difficile
Lost to Follow-Up
Drug-Related Side Effects and Adverse Reactions
Retrospective Studies
Mortality

Keywords

  • Hospital readmissions
  • Infectious disease
  • OPAT
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

Cite this

Outpatient Parenteral Therapy for Complicated Staphylococcus aureus Infections : A snapshot of processes and outcomes in the real world. / Townsend, Jennifer; Keller, Sara; Tibuakuu, Martin; Thakker, Sameer; Webster, Bailey; Siegel, Maya; Psoter, Kevin J.; Mansour, Omar; Perl, Trish.

In: Open Forum Infectious Diseases, Vol. 5, No. 11, 01.01.2018.

Research output: Contribution to journalArticle

Townsend, Jennifer ; Keller, Sara ; Tibuakuu, Martin ; Thakker, Sameer ; Webster, Bailey ; Siegel, Maya ; Psoter, Kevin J. ; Mansour, Omar ; Perl, Trish. / Outpatient Parenteral Therapy for Complicated Staphylococcus aureus Infections : A snapshot of processes and outcomes in the real world. In: Open Forum Infectious Diseases. 2018 ; Vol. 5, No. 11.
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