595. Characteristics of Antimicrobials Which Affect Parenteral Antibiotic Therapy Outcomes

BACKGROUND: Outpatient parenteral antibiotic therapy (OPAT) has reduced length of stay, decreased nosocomial infections, and improved patient satisfaction/outcomes. Factors for choosing candidates and regimens for OPAT include: type of infection, organisms, antibiotic side effects, number of antibiotics and frequency of administration. This study sought to evaluate if antibiotic type, frequency, and duration, are associated with complications, and particularly if vancomycin is associated with an increase rate of complication. METHODS: Retrospective chart review of Zablocki VA Medical Center patients, Milwaukee, WI discharged from 2013-2017 on OPAT evaluated types of infection, antimicrobial regimens, number of antibiotics, duration, frequency, adverse events and outcomes. Primary outcome analyzed was whether or not there was a complication. Complication defined as antibiotic change/dose adjustment, PICC line complication, or additional clinic/hospital visit RESULTS: 294 cases identified during study period. 286 (95.7%) were male. Most common antibiotics were vancomycin (78; 26.53%), daptomycin (42;14.9%) ertapenem (81, 27.55%), cefazolin (24;8.16%) and ceftriaxone (50;17%). Staphylococcus and Streptococcus were the most common organisms at 42.86% and 22.79% respectively. Univariate analysis of the most common antibiotics, maximum frequency and duration are summarized in table 1. A multivariable found cephalosporins were associated with no complication (OR 2.23, CI 1.20-4.35), and Vancomycin (OR 0.20, CI 0.11-0.36) and Gentamicin (OR 0.06, CI 0.06-0.58) were significantly associated with complication. Antibiotic frequency, duration, bacterial speciation were associated with no complication when controlling for antibiotic type Table 1 [Image: see text] CONCLUSION: Antibiotics given for longer durations or require more frequent monitoring like vancomycin may have higher rates of complications. This study supports the hypothesis that vancomycin and aminoglycosides are associated with complications even when controlling for duration and frequency; cephalosporins are associated with no complication. New, safer antibiotics like long acting lipoglycopeptides may provide alternatives to Vancomycin to diminish the burden on ancillary OPAT staff who deal with OPAT complications. DISCLOSURES: All Authors: No reported disclosures