Abel Mujal1, Joan Sola2, Manuel Hernandez2, Maria-Antonia Villarino3, Mireia Baylina4, Juan Tajan4, Joaquim Oristrell4. 1. Home Hospital Unit, Department of Internal Medicine, Sabadell Hospital, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain amujal@tauli.cat. 2. Home Hospital Unit, Department of Internal Medicine, Sabadell Hospital, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain. 3. Acute Geriatric Unit, Albada Centre Sociosanitari, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain. 4. Department of Internal Medicine, Sabadell Hospital, Corporació Sanitària Parc Taulí, Universitat Autònoma de Barcelona, Parc Taulí s/n, Sabadell, Barcelona, 08208, Spain.
Abstract
OBJECTIVES: We analyse the safety and effectiveness of self-outpatient parenteral antimicrobial therapy (s-OPAT) in older patients. METHODS: We prospectively evaluated all adults admitted to our home hospitalization unit (HHU) for s-OPAT in the period 2008-12 in whom the bacteria responsible for the infection were identified. We divided patients into three age groups: <65, 65-79 and ≥80 years. s-OPAT was administered by patients or their caregivers using elastomeric infusion devices. Effectiveness was assessed by analysing readmissions to hospital for inadequate control of underlying infection. Safety was assessed by analysing adverse events, catheter-related complications and readmission to hospital for causes unrelated to inadequate control of underlying infection. RESULTS: During the study period, 420 episodes of s-OPAT were registered in 351 patients: 139 (33.1%) in patients aged <65 years, 182 (43.3%) in those aged 65-79 years and 99 (23.6%) in those aged ≥80 years. Patients aged ≥80 years had a significantly lower Barthel index. The length of stay for s-OPAT and the complete HHU stay were similar in the three groups. Older people had similar changes in antibiotic treatment and hospital readmission rates due to poor control of underlying infection but higher readmission rates due to worsening of underlying diseases than younger adults. Adverse events and catheter-related complications were similar in the three age groups. CONCLUSIONS: s-OPAT administered by patients or their caregivers using elastomeric devices was safe and effective in the treatment of infections in older people.
OBJECTIVES: We analyse the safety and effectiveness of self-outpatient parenteral antimicrobial therapy (s-OPAT) in older patients. METHODS: We prospectively evaluated all adults admitted to our home hospitalization unit (HHU) for s-OPAT in the period 2008-12 in whom the bacteria responsible for the infection were identified. We divided patients into three age groups: <65, 65-79 and ≥80 years. s-OPAT was administered by patients or their caregivers using elastomeric infusion devices. Effectiveness was assessed by analysing readmissions to hospital for inadequate control of underlying infection. Safety was assessed by analysing adverse events, catheter-related complications and readmission to hospital for causes unrelated to inadequate control of underlying infection. RESULTS: During the study period, 420 episodes of s-OPAT were registered in 351 patients: 139 (33.1%) in patients aged <65 years, 182 (43.3%) in those aged 65-79 years and 99 (23.6%) in those aged ≥80 years. Patients aged ≥80 years had a significantly lower Barthel index. The length of stay for s-OPAT and the complete HHU stay were similar in the three groups. Older people had similar changes in antibiotic treatment and hospital readmission rates due to poor control of underlying infection but higher readmission rates due to worsening of underlying diseases than younger adults. Adverse events and catheter-related complications were similar in the three age groups. CONCLUSIONS: s-OPAT administered by patients or their caregivers using elastomeric devices was safe and effective in the treatment of infections in older people.
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