Efficacy and safety of a Belgian tertiary care outpatient parenteral antimicrobial therapy (OPAT) program

Abstract

Purpose

Evidence supports the implementation of outpatient parenteral antimicrobial therapy (OPAT) as standard of care. Until 2015 the overall experience with OPAT in Belgium remained limited. The aim of this study was to evaluate the efficacy and safety of a Belgian ‘OPAT at home’ program, which was implemented in University Hospitals Leuven starting from January 2017.

Methods

A mono-centric, prospective, observational study was carried out. All OPAT cases discharged between 10 January 2017 and 10 January 2019 were included in the study. Relevant demographic and clinical patient data were collected. The outcomes were clinical cure rate, OPAT related readmission rate, adverse event rate and patients’ satisfaction.

Results

Over the two-year study period, 152 OPAT episodes were started in 130 patients, resulting in 3153 avoided hospitalization days which corresponds to 5.4 freed hospital beds. Urinary tract infections accounted for 40.8% of OPAT courses and temocillin was the most frequently used antibiotic (24.3%). Cure was achieved in 97.9% of the OPAT episodes. During 22 (14.5%) OPAT episodes, patients experienced adverse events, including line related adverse events (7.9%) and adverse drug events (6.6%). An OPAT related readmission rate of 9.2% was observed, mostly related to line-associated adverse events. All patients who completed the satisfaction survey (n = 23) were very satisfied with their OPAT course.

Conclusion

The University Hospitals Leuven OPAT program is associated with a high level of clinical cure and low all-cause readmission and adverse event rates. Improvement actions are described to further reduce the readmission rate to less than 5.0%.

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Acknowledgements

We acknowledge the contribution of the multidisciplinary OPAT team of University Hospitals Leuven.

Funding

This study was not funded.

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Corresponding author

Correspondence to Charlotte Quintens.

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Conflict of interest

All authors declare that they have no competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Ethics Committee for Research, University Hospitals Leuven, Belgium; S60847) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Quintens, C., Steffens, E., Jacobs, K. et al. Efficacy and safety of a Belgian tertiary care outpatient parenteral antimicrobial therapy (OPAT) program. Infection 48, 357–366 (2020). https://doi.org/10.1007/s15010-020-01398-4

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Keywords

  • Outpatient parenteral antimicrobial therapy
  • OPAT
  • Hospital at home
  • Home care
  • Antibiotics
  • Intravascular catheter care