ASM Microbe
ASM Microbe
September 23, 2015
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Use of OPAT suggests inclusion in antibiotic stewardship program

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SAN DIEGO — The widespread use of pediatric outpatient parenteral antimicrobial therapy positions it as a primary candidate for an antibiotic stewardship program, according to data presented at ICAAC 2015.

“Outpatient parenteral antimicrobial therapy [OPAT] is an important venue for a pediatrics antibiotic stewardship program,” study researcher Gayatri Mirani, MD, from Tulane University School of Medicine, told Infectious Diseases in Children. “Our study at Children’s Hospital in New Orleans highlights a need for a standardized approach to OPAT to improve outcomes.”

Photo of Gayatri Mirani

Gayatri Mirani

To gauge OPAT usage, the researchers reviewed medical records of all patients discharged from the hospital between 2012 and 2013. Fifty-eight patients — including 40 admitted to orthopedic or general pediatric services with osteomyelitis — received OPAT at discharge. Most patients had hospital stays of 10 to 14 days, and OPAT was conducted for 4 weeks.

The most common bacteria isolate found in the study was Staphylococcus aureus. It was treated most often with clindamycin, ceftriaxone, vancomycin, cefazolin and nafcillin/oxacillin.

The researchers said pediatric infectious disease services was consulted in only 66% of OPAT cases. In 84% of them, therapy modification resulted in a change in antibiotic class. Thirteen study patients returned to the hospital because of adverse events. This included 11 readmitted within 1 month of discharge.

“Pediatric infectious diseases physicians play an integral role in recommending appropriate antibiotics and length of therapy, and managing adverse events related to prolonged antimicrobial therapy,” Mirani said. – by David Costill

Reference:

Mirani G, et al. Poster: S-927. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 17-21, 2015; San Diego. 

Disclosure: The researchers report no relevant financial disclosures.