Outpatient parenteral antibacterial therapy: myths and reality
DOI: https://doi.org/10.29296/25877305-2023-12-01
Issue:
12
Year:
2023
The article is devoted to a new hospital-replacing technology – outpatient parenteral antibacterial therapy (APAT). The indications, contraindications, techniques and clinical effectiveness of APAT are discussed in detail. The benefits of APAT are realized when time-dependent antimicrobial agents are prescribed. Consistent drug delivery is achieved through the use of elastomeric pumps. The use of APAT increases patients' motivation for treatment and reduces the burden on medical staff. The introduction of APAT, in addition to clinical benefits, contributes to significant savings in the financial resources of a medical institution.
Keywords:
hospital-substitution technologies
outpatient parenteral antibacterial therapy
elastomeric pumps.
References:
- Пасечник И.Н. Программа ускоренного выздоровления после хирургических вмешательств: мультидисциплинарный подход и организационные проблемы. Заместитель главного врача. 2016; 4: 20–7 [Pasechnik I.N. Program of accelerated recovery after surgical interventions: multidisciplinary approach and organizational problems. Zamestitel' glavnogo vracha. 2016; 4: 20–7 (in Russ.)].
- Затевахин И.И., Пасечник И.Н. Программа ускоренного выздоровления в хирургии (FAST TRACK) внедрена. Что дальше? Вестник хирургии им. И.И. Грекова. 2018; 177 (3): 70–5 [Zatevachin I.I., asechnik I.N. The program of accelerated recovery in surgery (fast trak) has been introduced. Wgat’s the next? Grekov's Bulletin of Surgery. 2018; 177 (3): 70–5 (in Russ.)]. DOI: 10.24884/0042-4625-2018-177-3-70-75
- Егоров Д.В., Лазарева Ю.А., Селиверстов П.В. Подходы к ведению пациентов хирургического профиля с антибиотик-ассоциированной диареей легкого течения. Медицинский Совет. 2023; 18: 128–33 [Egorov D.V., Lazareva Yu.A., Seliverstov P.V. Approaches to the management of surgical patients with antibiotic-associated mild diarrhea. Medical Council. 2023; 18: 128–33 (in Russ.)]. DOI: 10.21518/ms2023-385
- Johnson T.M., Webster L.C.W., Mehta M. et al. Pushing the agenda for intravenous push administration in outpatient parenteral antimicrobial therapy. Ther Adv Infect Dis. 2023; 10: 20499361231193920. DOI: 10.1177/20499361231193920
- Norris A.H., Shrestha N.K., Allison G.M. et al. 2018 Infectious Diseases Society of America Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy. Clin Infect Dis. 2019; 68 (1): e1–35. DOI: 10.1093/cid/CIY745
- Chapman A.L.N., Patel S., Horner C. et al. Updated good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults and children in the UK. JAC Antimicrob Resist. 2019; 1 (2): dlz026. DOI: 10.1093/jacamr/dlz026
- National Home Infusion Association. NHIF infusion industry trends report. URL: https://nhia.org/nhif/nhif_infusion_industry_trends_report
- Fortune Business Insights. U.S. home infusion therapy market size, share and COVID-19 impact analysis, by product (devices, drugs, and services), by indication (anti-infective, chemotherapy, hydration therapy, enteral nutrition, total parenteral nutrition, immunoglobulins, and others), and forecast, 2021–2028. URL: https:/www.fortunebusinessinsights.com/u-s-home-infusion-therapy-market-106327
- Rucker R.W., Harrison G.M. Outpatient intravenous medications in the management of cystic fibrosis. Pediatrics. 1974; 54 (3): 358–60.
- Williams D.N., Baker C.A., Kind A.C. et al. The history and evolution of outpatient parenteral antibiotic therapy (OPAT). Int J Antimicrob Agents. 2015; 46 (3): 307–12. DOI: 10.1016/j.ijantimicag.2015.07.001
- Mahoney M.V., Childs-Kean L.M., Khan P. et al. Recent Updates in Antimicrobial Stewardship in Outpatient Parenteral Antimicrobial Therapy. Curr Infect Dis Rep. 2021; 23 (12): 24. DOI: 10.1007/s11908-021-00766-x
- Loriaux A., Desmond M., Li P.C. A Primer on Home Infusion Administration Methods. Open Forum Infect Dis. 2022; 9 (12): ofac525. DOI: 10.1093/ofid/ofac525
- Cassettari V., Novato N., Onuchic M.H.F. Antimicrobial stewardship in the outpatient parenteral antimicrobial therapy (OPAT) setting: the impact of prescription assessment by an infectious diseases specialist. Braz J Infect Dis. 2021; 25 (2): 101560. DOI: 10.1016/j.bjid.2021.101560
- Wang W. Tolerability of hypertonic injectables. Int J Pharm. 2015; 490 (1-2): 308–15. DOI: 10.1016/j.ijpharm.2015.05.069
- Loeuille G., D'Huart E., Vigneron J. et al. Stability Studies of 16 Antibiotics for Continuous Infusion in Intensive Care Units and for Performing Outpatient Parenteral Antimicrobial Therapy. Antibiotics (Basel). 2022; 11 (4): 458. DOI: 10.3390/antibiotics11040458
- Rodriguez-Martinez L., Castro-Balado A., Hermelo-Vidal G. et al. Ampicillin Stability in a Portable Elastomeric Infusion Pump: A Step Forward in Outpatient Parenteral Antimicrobial Therapy. Pharmaceutics. 2023; 15 (8): 2099. DOI: 10.3390/pharmaceutics15082099
- Voumard R., Gardiol C., André P. et al. Efficacy and safety of continuous infusions with elastomeric pumps for outpatient parenteral antimicrobial therapy (OPAT): an observational study. J Antimicrob Chemother. 2018; 73 (9): 2540–5. DOI: 10.1093/jac/dky224
- Thijs L., Quintens C., Vander Elst L. et al. Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program. Antibiotics (Basel). 2022; 11 (5): 702. DOI: 10.3390/antibiotics11050702
- Poole S.M., Nowobilski-Vasilios A., Free F. Intravenous push medications in the home. J Intraven Nurs. 1999; 22 (4): 209–15.
- Hamad Y., Dodda S., Frank A. et al. Perspectives of Patients on Outpatient Parenteral Antimicrobial Therapy: Experiences and Adherence. Open Forum Infect Dis. 2020; 7 (6): ofaa205. DOI: 10.1093/ofid/ofaa205
- Пасечник И.Н., Рыбинцев В.Ю., Талызин П.А. Безопасность фармакотерапии: что нового? Анестезиология и реаниматология. 2019; 5: 47–50 [Pasechnik I.N., Rybintsev V.Yu., Talyzin P.A. Safety of pharmacotherapy: what's new? Russian Journal of Anesthesiology and Reanimatology. 2019; 5: 47–50 (in Russ.)]. DOI.: 10.17116/anaesthesiology201905147
- Staples J.A., Ho M., Ferris D. et al. Outpatient Versus Inpatient Intravenous Antimicrobial Therapy: A Population-Based Observational Cohort Study of Adverse Events and Costs. Clin Infect Dis. 2022; 75 (11): 1921–9. DOI: 10.1093/cid/ciac298
- Farmer E.C.W., Seaton R.S. Recent innovations and new applications of outpatient parenteral antimicrobial therapy. Expert Rev Anti Infect Ther. 2021; 19 (1): 55–64. DOI: 10.1080/14787210.2020.1810566
- Mackintosh C.L., White H.A., Seaton R.A. Outpatient parenteral antibiotic therapy (OPAT) for bone and joint infections: experience from a UK teaching hospital-based service. J Antimicrob Chemother. 2011; 66 (2): 408–15. DOI: 10.1093/jac/dkq445
- Kutubi A., O'Brien L., Murphy B. et al. A single centre experience of prosthetic joint infection outcomes with outpatient parenteral antimicrobial therapy. Heliyon. 2023; 9 (4): e15212. DOI: 10.1016/j.heliyon.2023.e15212
- Rezar R., Lichtenauer M., Haar M. et al. Infective endocarditis – A review of current therapy and future challenges. Hellenic J Cardiol. 2021; 62 (3): 190–200. DOI: 10.1016/j.hjc.2020.10.007
- Rajaratnam D., Rajaratnam R. Outpatient Parenteral Antimicrobial Therapy for Infective Endocarditis-Model of Care. Antibiotics (Basel). 2023; 12 (2): 355. DOI: 10.3390/antibiotics12020355
- Cahill T.J., Baddour L.M., Habib G. et al. Challenges in Infective Endocarditis. J Am Coll Cardiol. 2017; 69 (3): 325–44. DOI: 10.1016/j.jacc.2016.10.066
- Fink D.L., Collins S., Barret R. et al. Shortening duration of ertapenem in outpatient parenteral antimicrobial therapy for complicated urinary tract infections: A retrospective study. PLoS One. 2019; 14 (9): e0223130. DOI: 10.1371/journal.pone.0223130
- Ponce González M.A., Mirón Rubio M., Mujal Martinez A. et al. Effectiveness and safety of outpatient parenteral antimicrobial therapy in acute exacerbation of chronic obstructive pulmonary disease. Int J Clin Pract. 2017; 71 (12). DOI: 10.1111/ijcp.13022
- Castillo-Fernández N., Pérez-Crespo P.M.M., Salamanca-Rivera E. et al. Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort. Antibiotics (Basel). 2023; 12 (1): 129. DOI: 10.3390/antibiotics12010129
- Carter B., Fisher-Smith D., Porter D. et al. Paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT): An e-survey of the experiences of parents and clinicians. PLoS One. 2021; 16 (4): e0249514. DOI: 10.1371/journal.pone.0249514