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Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis

BACKGROUND: Patients with bronchiectasis often require hospitalisation for the administration of intravenous antibiotics for the management of acute exacerbations. Increasingly, Outpatient Parenteral Antibiotic Therapy (OPAT) services have become available as a potential alternative for domiciliary...

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Autores principales: Tu, Jacky, Al Harasi, Mohammed, Pallin, Michael, Daley, Chris, Rogers, Benjamin A., King, Paul T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10559547/
https://www.ncbi.nlm.nih.gov/pubmed/37809890
http://dx.doi.org/10.1016/j.heliyon.2023.e19968
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author Tu, Jacky
Al Harasi, Mohammed
Pallin, Michael
Daley, Chris
Rogers, Benjamin A.
King, Paul T.
author_facet Tu, Jacky
Al Harasi, Mohammed
Pallin, Michael
Daley, Chris
Rogers, Benjamin A.
King, Paul T.
author_sort Tu, Jacky
collection PubMed
description BACKGROUND: Patients with bronchiectasis often require hospitalisation for the administration of intravenous antibiotics for the management of acute exacerbations. Increasingly, Outpatient Parenteral Antibiotic Therapy (OPAT) services have become available as a potential alternative for domiciliary management. AIMS: This study assessed outcomes in both cystic fibrosis (CF) and non-CF bronchiectasis patients who received OPAT for the management of an acute exacerbation of bronchiectasis. METHODS: A retrospective study of consecutive subjects was done in both CF and non-CF groups in a large metropolitan Health Service in Australia from 2016 to 2022. RESULTS: There were 51 episodes of care in the non-CF group (22 subjects) and 73 episodes in the CF group (13 subjects). The non-CF group were nearly all treated with once daily domiciliary intravenous (IV) ceftriaxone (49/51 episodes) for a duration of 9.1 ± 3.0 days (mean and standard deviation (SD)) via a peripherally inserted venous canula (84% of episodes). In contrast, the CF group generally received dual IV antibiotics (64% of episodes), with an average duration of 16.8 ± 6.3 days via central venous access (100%). In the non-CF group, the admission rate to hospital after 1 month was 9.6% and in the CF group was 0%. At 3 and 6 months the readmission rate for the non-CF group was 15.7% and 19.6% and CF group was 21.9% and 31.5%. There was a low rate of complications for the OPAT admissions (2% for the non-CF group and 7% for CF group). CONCLUSIONS: OPAT is a viable alternative for the management of bronchiectasis exacerbations.
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spelling pubmed-105595472023-10-08 Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis Tu, Jacky Al Harasi, Mohammed Pallin, Michael Daley, Chris Rogers, Benjamin A. King, Paul T. Heliyon Research Article BACKGROUND: Patients with bronchiectasis often require hospitalisation for the administration of intravenous antibiotics for the management of acute exacerbations. Increasingly, Outpatient Parenteral Antibiotic Therapy (OPAT) services have become available as a potential alternative for domiciliary management. AIMS: This study assessed outcomes in both cystic fibrosis (CF) and non-CF bronchiectasis patients who received OPAT for the management of an acute exacerbation of bronchiectasis. METHODS: A retrospective study of consecutive subjects was done in both CF and non-CF groups in a large metropolitan Health Service in Australia from 2016 to 2022. RESULTS: There were 51 episodes of care in the non-CF group (22 subjects) and 73 episodes in the CF group (13 subjects). The non-CF group were nearly all treated with once daily domiciliary intravenous (IV) ceftriaxone (49/51 episodes) for a duration of 9.1 ± 3.0 days (mean and standard deviation (SD)) via a peripherally inserted venous canula (84% of episodes). In contrast, the CF group generally received dual IV antibiotics (64% of episodes), with an average duration of 16.8 ± 6.3 days via central venous access (100%). In the non-CF group, the admission rate to hospital after 1 month was 9.6% and in the CF group was 0%. At 3 and 6 months the readmission rate for the non-CF group was 15.7% and 19.6% and CF group was 21.9% and 31.5%. There was a low rate of complications for the OPAT admissions (2% for the non-CF group and 7% for CF group). CONCLUSIONS: OPAT is a viable alternative for the management of bronchiectasis exacerbations. Elsevier 2023-09-09 /pmc/articles/PMC10559547/ /pubmed/37809890 http://dx.doi.org/10.1016/j.heliyon.2023.e19968 Text en © 2023 The Authors. Published by Elsevier Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Research Article
Tu, Jacky
Al Harasi, Mohammed
Pallin, Michael
Daley, Chris
Rogers, Benjamin A.
King, Paul T.
Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title_full Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title_fullStr Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title_full_unstemmed Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title_short Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title_sort outpatient parenteral antibiotic therapy (opat) for the management of bronchiectasis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10559547/
https://www.ncbi.nlm.nih.gov/pubmed/37809890
http://dx.doi.org/10.1016/j.heliyon.2023.e19968
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