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Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program

Vancomycin is commonly used in outpatient parenteral antimicrobial therapy (OPAT) of Gram-positive infections. Therapeutic drug monitoring and adverse event monitoring pose a challenge. Outcome data of vancomycin in OPAT (vOPAT) are limited. The study aim was to report the safety and efficacy of a s...

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Autores principales: Thijs, Lore, Quintens, Charlotte, Vander Elst, Lotte, De Munter, Paul, Depypere, Melissa, Metsemakers, Willem-Jan, Vles, Georges, Liesenborghs, Astrid, Neefs, Jens, Peetermans, Willy E., Spriet, Isabel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137986/
https://www.ncbi.nlm.nih.gov/pubmed/35625346
http://dx.doi.org/10.3390/antibiotics11050702
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author Thijs, Lore
Quintens, Charlotte
Vander Elst, Lotte
De Munter, Paul
Depypere, Melissa
Metsemakers, Willem-Jan
Vles, Georges
Liesenborghs, Astrid
Neefs, Jens
Peetermans, Willy E.
Spriet, Isabel
author_facet Thijs, Lore
Quintens, Charlotte
Vander Elst, Lotte
De Munter, Paul
Depypere, Melissa
Metsemakers, Willem-Jan
Vles, Georges
Liesenborghs, Astrid
Neefs, Jens
Peetermans, Willy E.
Spriet, Isabel
author_sort Thijs, Lore
collection PubMed
description Vancomycin is commonly used in outpatient parenteral antimicrobial therapy (OPAT) of Gram-positive infections. Therapeutic drug monitoring and adverse event monitoring pose a challenge. Outcome data of vancomycin in OPAT (vOPAT) are limited. The study aim was to report the safety and efficacy of a structured vOPAT program implemented in the University Hospitals Leuven. The program provides continuous elastomeric infusion of vancomycin at home with biweekly follow-up at the outpatient clinic. Demographics, clinical, biochemical and treatment parameters, target attainment parameters and clinical outcomes were recorded. An e-survey was conducted to assess patient satisfaction. Thirty-five vOPAT episodes in 32 patients were included. During 206 follow-up consultations, 203 plasma concentration measurements were registered with a median vancomycin plasma concentration of 22.5 mg/L (range 6.6–32.0). The majority of concentrations (68.5%) were within the therapeutic range (20.0–25.0 mg/L). Adverse event rates, including drug- (5.7%) and catheter-related (5.7%) events, were low. For 32 vOPAT episodes, a clinical cure rate of 100% was observed. All patients who completed the e-survey were satisfied with their vOPAT course. These findings show that a structured vOPAT program with rigorous follow-up provides safe and effective ambulatory treatment of patients with vancomycin in continuous infusion.
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spelling pubmed-91379862022-05-28 Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program Thijs, Lore Quintens, Charlotte Vander Elst, Lotte De Munter, Paul Depypere, Melissa Metsemakers, Willem-Jan Vles, Georges Liesenborghs, Astrid Neefs, Jens Peetermans, Willy E. Spriet, Isabel Antibiotics (Basel) Article Vancomycin is commonly used in outpatient parenteral antimicrobial therapy (OPAT) of Gram-positive infections. Therapeutic drug monitoring and adverse event monitoring pose a challenge. Outcome data of vancomycin in OPAT (vOPAT) are limited. The study aim was to report the safety and efficacy of a structured vOPAT program implemented in the University Hospitals Leuven. The program provides continuous elastomeric infusion of vancomycin at home with biweekly follow-up at the outpatient clinic. Demographics, clinical, biochemical and treatment parameters, target attainment parameters and clinical outcomes were recorded. An e-survey was conducted to assess patient satisfaction. Thirty-five vOPAT episodes in 32 patients were included. During 206 follow-up consultations, 203 plasma concentration measurements were registered with a median vancomycin plasma concentration of 22.5 mg/L (range 6.6–32.0). The majority of concentrations (68.5%) were within the therapeutic range (20.0–25.0 mg/L). Adverse event rates, including drug- (5.7%) and catheter-related (5.7%) events, were low. For 32 vOPAT episodes, a clinical cure rate of 100% was observed. All patients who completed the e-survey were satisfied with their vOPAT course. These findings show that a structured vOPAT program with rigorous follow-up provides safe and effective ambulatory treatment of patients with vancomycin in continuous infusion. MDPI 2022-05-23 /pmc/articles/PMC9137986/ /pubmed/35625346 http://dx.doi.org/10.3390/antibiotics11050702 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Thijs, Lore
Quintens, Charlotte
Vander Elst, Lotte
De Munter, Paul
Depypere, Melissa
Metsemakers, Willem-Jan
Vles, Georges
Liesenborghs, Astrid
Neefs, Jens
Peetermans, Willy E.
Spriet, Isabel
Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program
title Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program
title_full Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program
title_fullStr Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program
title_full_unstemmed Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program
title_short Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program
title_sort clinical efficacy and safety of vancomycin continuous infusion in patients treated at home in an outpatient parenteral antimicrobial therapy program
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137986/
https://www.ncbi.nlm.nih.gov/pubmed/35625346
http://dx.doi.org/10.3390/antibiotics11050702
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