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Current Status of Outpatient Parenteral Antimicrobial Therapy in Korea: Experience of a Single University-Affiliated Acute-Care Hospital

BACKGROUND: Systematic protocols for the management of outpatient parenteral antimicrobial therapy (OPAT) and information on the current status of a prescription of parenteral antibiotics for outpatients and referred patients are lacking in the Korea. This study aimed to describe the current status...

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Autores principales: Heo, Eunjeong, Choi, Yoonhee, Kim, Hyung-sook, Namgung, Hyung Wook, Lee, Eunsook, Lee, Euni, Lee, Ju-Yeun, Jung, Jongtak, Kim, Eu Suk, Kim, Hong Bin, Song, Kyoung-Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Infectious Diseases; Korean Society for Antimicrobial Therapy; The Korean Society for AIDS 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323533/
https://www.ncbi.nlm.nih.gov/pubmed/36603822
http://dx.doi.org/10.3947/ic.2022.0092
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author Heo, Eunjeong
Choi, Yoonhee
Kim, Hyung-sook
Namgung, Hyung Wook
Lee, Eunsook
Lee, Euni
Lee, Ju-Yeun
Jung, Jongtak
Kim, Eu Suk
Kim, Hong Bin
Song, Kyoung-Ho
author_facet Heo, Eunjeong
Choi, Yoonhee
Kim, Hyung-sook
Namgung, Hyung Wook
Lee, Eunsook
Lee, Euni
Lee, Ju-Yeun
Jung, Jongtak
Kim, Eu Suk
Kim, Hong Bin
Song, Kyoung-Ho
author_sort Heo, Eunjeong
collection PubMed
description BACKGROUND: Systematic protocols for the management of outpatient parenteral antimicrobial therapy (OPAT) and information on the current status of a prescription of parenteral antibiotics for outpatients and referred patients are lacking in the Korea. This study aimed to describe the current status of OPAT at a tertiary care hospital in Korea. MATERIALS AND METHODS: This was a retrospective study of outpatients and referral patients who were prescribed parenteral antibiotics from July to December 2019. We reviewed the prescribed antimicrobials, indications for antimicrobial therapy, institution administering the antimicrobial injections, and pre- and post-prescription management. RESULTS: Of the 577 prescriptions assessed in this study, 399 (69.2%) and 178 (30.8%) were delivered using the referral and outpatient models, respectively. About 70% of OPATs were prescribed in the pulmonology, infectious diseases, orthopedics, gastroenterology, and hematology departments. Five antibiotics (ertapenem [26.0%], ceftriaxone [12.8%], kanamycin [11.8%], amikacin [10.1%], and cefazolin [8.5%]) accounted for 69.2% of the total OPATs. Urinary tract (27.3%), respiratory (20.8%), and intra-abdominal (15.9%) infections were the most frequent indications for OPAT. After prescription, there were 295 (73.9%) and 150 (84.3%) follow-up visits in the referral and outpatient models, respectively (P <0.05). Laboratory tests necessary for monitoring were fully performed for 274 (47.5%) prescriptions. CONCLUSION: We found that a significant number of OPATs were prescribed, follow-up visits were not performed in the case of about a quarter of prescriptions, and laboratory monitoring was not fully conducted in more than half of the cases. Therefore, it is necessary to establish an appropriate management program for OPAT. Considering the limited resources and the distribution of OPAT prescriptions, an effective strategy may be to select the frequently-used antibiotics or frequently-prescribing departments and start the program with them.
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spelling pubmed-103235332023-07-07 Current Status of Outpatient Parenteral Antimicrobial Therapy in Korea: Experience of a Single University-Affiliated Acute-Care Hospital Heo, Eunjeong Choi, Yoonhee Kim, Hyung-sook Namgung, Hyung Wook Lee, Eunsook Lee, Euni Lee, Ju-Yeun Jung, Jongtak Kim, Eu Suk Kim, Hong Bin Song, Kyoung-Ho Infect Chemother Original Article BACKGROUND: Systematic protocols for the management of outpatient parenteral antimicrobial therapy (OPAT) and information on the current status of a prescription of parenteral antibiotics for outpatients and referred patients are lacking in the Korea. This study aimed to describe the current status of OPAT at a tertiary care hospital in Korea. MATERIALS AND METHODS: This was a retrospective study of outpatients and referral patients who were prescribed parenteral antibiotics from July to December 2019. We reviewed the prescribed antimicrobials, indications for antimicrobial therapy, institution administering the antimicrobial injections, and pre- and post-prescription management. RESULTS: Of the 577 prescriptions assessed in this study, 399 (69.2%) and 178 (30.8%) were delivered using the referral and outpatient models, respectively. About 70% of OPATs were prescribed in the pulmonology, infectious diseases, orthopedics, gastroenterology, and hematology departments. Five antibiotics (ertapenem [26.0%], ceftriaxone [12.8%], kanamycin [11.8%], amikacin [10.1%], and cefazolin [8.5%]) accounted for 69.2% of the total OPATs. Urinary tract (27.3%), respiratory (20.8%), and intra-abdominal (15.9%) infections were the most frequent indications for OPAT. After prescription, there were 295 (73.9%) and 150 (84.3%) follow-up visits in the referral and outpatient models, respectively (P <0.05). Laboratory tests necessary for monitoring were fully performed for 274 (47.5%) prescriptions. CONCLUSION: We found that a significant number of OPATs were prescribed, follow-up visits were not performed in the case of about a quarter of prescriptions, and laboratory monitoring was not fully conducted in more than half of the cases. Therefore, it is necessary to establish an appropriate management program for OPAT. Considering the limited resources and the distribution of OPAT prescriptions, an effective strategy may be to select the frequently-used antibiotics or frequently-prescribing departments and start the program with them. The Korean Society of Infectious Diseases; Korean Society for Antimicrobial Therapy; The Korean Society for AIDS 2023-06 2022-12-16 /pmc/articles/PMC10323533/ /pubmed/36603822 http://dx.doi.org/10.3947/ic.2022.0092 Text en Copyright © 2023 by The Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, and The Korean Society for AIDS https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Heo, Eunjeong
Choi, Yoonhee
Kim, Hyung-sook
Namgung, Hyung Wook
Lee, Eunsook
Lee, Euni
Lee, Ju-Yeun
Jung, Jongtak
Kim, Eu Suk
Kim, Hong Bin
Song, Kyoung-Ho
Current Status of Outpatient Parenteral Antimicrobial Therapy in Korea: Experience of a Single University-Affiliated Acute-Care Hospital
title Current Status of Outpatient Parenteral Antimicrobial Therapy in Korea: Experience of a Single University-Affiliated Acute-Care Hospital
title_full Current Status of Outpatient Parenteral Antimicrobial Therapy in Korea: Experience of a Single University-Affiliated Acute-Care Hospital
title_fullStr Current Status of Outpatient Parenteral Antimicrobial Therapy in Korea: Experience of a Single University-Affiliated Acute-Care Hospital
title_full_unstemmed Current Status of Outpatient Parenteral Antimicrobial Therapy in Korea: Experience of a Single University-Affiliated Acute-Care Hospital
title_short Current Status of Outpatient Parenteral Antimicrobial Therapy in Korea: Experience of a Single University-Affiliated Acute-Care Hospital
title_sort current status of outpatient parenteral antimicrobial therapy in korea: experience of a single university-affiliated acute-care hospital
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323533/
https://www.ncbi.nlm.nih.gov/pubmed/36603822
http://dx.doi.org/10.3947/ic.2022.0092
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