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Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort
It is not known whether sequential outpatient parenteral antimicrobial (OPAT) is as safe and effective as conventional hospitalization in patients with S. aureus bacteremia (SAB). A post-hoc analysis of the comparative effectiveness of conventional hospitalization versus sequential OPAT was performe...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9854520/ https://www.ncbi.nlm.nih.gov/pubmed/36671330 http://dx.doi.org/10.3390/antibiotics12010129 |
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author | Castillo-Fernández, Nerea Pérez-Crespo, Pedro María Martínez Salamanca-Rivera, Elena Herrera-Hidalgo, Laura de Alarcón, Arístides Navarro-Amuedo, María Dolores Marrodán Ciordia, Teresa Pérez-Rodríguez, María Teresa Sevilla-Blanco, Juan Jover-Saenz, Alfredo Fernández-Suárez, Jonathan Armiñanzas-Castillo, Carlos Reguera-Iglesias, José María Natera Kindelán, Clara Boix-Palop, Lucía León Jiménez, Eva Galán-Sánchez, Fátima del Arco Jiménez, Alfonso Bahamonde-Carrasco, Alberto Vinuesa García, David Smithson Amat, Alejandro Cuquet Pedragosa, Jordi Reche Molina, Isabel María Pérez Camacho, Inés Merino de Lucas, Esperanza Gutiérrez-Gutiérrez, Belén Rodríguez Baño, Jesús López Cortés, Luis Eduardo |
author_facet | Castillo-Fernández, Nerea Pérez-Crespo, Pedro María Martínez Salamanca-Rivera, Elena Herrera-Hidalgo, Laura de Alarcón, Arístides Navarro-Amuedo, María Dolores Marrodán Ciordia, Teresa Pérez-Rodríguez, María Teresa Sevilla-Blanco, Juan Jover-Saenz, Alfredo Fernández-Suárez, Jonathan Armiñanzas-Castillo, Carlos Reguera-Iglesias, José María Natera Kindelán, Clara Boix-Palop, Lucía León Jiménez, Eva Galán-Sánchez, Fátima del Arco Jiménez, Alfonso Bahamonde-Carrasco, Alberto Vinuesa García, David Smithson Amat, Alejandro Cuquet Pedragosa, Jordi Reche Molina, Isabel María Pérez Camacho, Inés Merino de Lucas, Esperanza Gutiérrez-Gutiérrez, Belén Rodríguez Baño, Jesús López Cortés, Luis Eduardo |
author_sort | Castillo-Fernández, Nerea |
collection | PubMed |
description | It is not known whether sequential outpatient parenteral antimicrobial (OPAT) is as safe and effective as conventional hospitalization in patients with S. aureus bacteremia (SAB). A post-hoc analysis of the comparative effectiveness of conventional hospitalization versus sequential OPAT was performed in two prospective Spanish cohorts of patients with S. aureus bacteremia. The PROBAC cohort is a national, multicenter, prospective observational cohort of patients diagnosed in 22 Spanish hospitals between October 2016 and March 2017. The DOMUS OPAT cohort is a prospective observational cohort including patients from two university hospitals in Seville, Spain from 2012 to 2021. Multivariate regression was performed, including a propensity score (PS) for receiving OPAT, stratified analysis according to PS quartiles, and matched pair analyses based on PS. Four hundred and thirteen patients were included in the analysis: 150 in sequential OPAT and 263 in the full hospitalization therapy group. In multivariate analysis, including PS and center effect as covariates, 60-day treatment failure was lower in the OPAT group than in the full hospitalization group (p < 0.001; OR 0.275, 95%CI 0.129–0.584). In the PS-based matched analyses, sequential treatment under OPAT was not associated with higher 60-day treatment failure (p = 0.253; adjusted OR 0.660; % CI 0.324–1.345). OPAT is a safe and effective alternative to conventional in-patient therapy for completion of treatment in well-selected patients with SAB, mainly those associated with a low-risk source and without end-stage kidney disease. |
format | Online Article Text |
id | pubmed-9854520 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-98545202023-01-21 Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort Castillo-Fernández, Nerea Pérez-Crespo, Pedro María Martínez Salamanca-Rivera, Elena Herrera-Hidalgo, Laura de Alarcón, Arístides Navarro-Amuedo, María Dolores Marrodán Ciordia, Teresa Pérez-Rodríguez, María Teresa Sevilla-Blanco, Juan Jover-Saenz, Alfredo Fernández-Suárez, Jonathan Armiñanzas-Castillo, Carlos Reguera-Iglesias, José María Natera Kindelán, Clara Boix-Palop, Lucía León Jiménez, Eva Galán-Sánchez, Fátima del Arco Jiménez, Alfonso Bahamonde-Carrasco, Alberto Vinuesa García, David Smithson Amat, Alejandro Cuquet Pedragosa, Jordi Reche Molina, Isabel María Pérez Camacho, Inés Merino de Lucas, Esperanza Gutiérrez-Gutiérrez, Belén Rodríguez Baño, Jesús López Cortés, Luis Eduardo Antibiotics (Basel) Article It is not known whether sequential outpatient parenteral antimicrobial (OPAT) is as safe and effective as conventional hospitalization in patients with S. aureus bacteremia (SAB). A post-hoc analysis of the comparative effectiveness of conventional hospitalization versus sequential OPAT was performed in two prospective Spanish cohorts of patients with S. aureus bacteremia. The PROBAC cohort is a national, multicenter, prospective observational cohort of patients diagnosed in 22 Spanish hospitals between October 2016 and March 2017. The DOMUS OPAT cohort is a prospective observational cohort including patients from two university hospitals in Seville, Spain from 2012 to 2021. Multivariate regression was performed, including a propensity score (PS) for receiving OPAT, stratified analysis according to PS quartiles, and matched pair analyses based on PS. Four hundred and thirteen patients were included in the analysis: 150 in sequential OPAT and 263 in the full hospitalization therapy group. In multivariate analysis, including PS and center effect as covariates, 60-day treatment failure was lower in the OPAT group than in the full hospitalization group (p < 0.001; OR 0.275, 95%CI 0.129–0.584). In the PS-based matched analyses, sequential treatment under OPAT was not associated with higher 60-day treatment failure (p = 0.253; adjusted OR 0.660; % CI 0.324–1.345). OPAT is a safe and effective alternative to conventional in-patient therapy for completion of treatment in well-selected patients with SAB, mainly those associated with a low-risk source and without end-stage kidney disease. MDPI 2023-01-09 /pmc/articles/PMC9854520/ /pubmed/36671330 http://dx.doi.org/10.3390/antibiotics12010129 Text en © 2023 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 Castillo-Fernández, Nerea Pérez-Crespo, Pedro María Martínez Salamanca-Rivera, Elena Herrera-Hidalgo, Laura de Alarcón, Arístides Navarro-Amuedo, María Dolores Marrodán Ciordia, Teresa Pérez-Rodríguez, María Teresa Sevilla-Blanco, Juan Jover-Saenz, Alfredo Fernández-Suárez, Jonathan Armiñanzas-Castillo, Carlos Reguera-Iglesias, José María Natera Kindelán, Clara Boix-Palop, Lucía León Jiménez, Eva Galán-Sánchez, Fátima del Arco Jiménez, Alfonso Bahamonde-Carrasco, Alberto Vinuesa García, David Smithson Amat, Alejandro Cuquet Pedragosa, Jordi Reche Molina, Isabel María Pérez Camacho, Inés Merino de Lucas, Esperanza Gutiérrez-Gutiérrez, Belén Rodríguez Baño, Jesús López Cortés, Luis Eduardo Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort |
title | Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort |
title_full | Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort |
title_fullStr | Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort |
title_full_unstemmed | Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort |
title_short | Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort |
title_sort | conventional hospitalization versus sequential outpatient parenteral antibiotic therapy for staphylococcus aureus bacteremia: post-hoc analysis of a multicenter observational cohort |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9854520/ https://www.ncbi.nlm.nih.gov/pubmed/36671330 http://dx.doi.org/10.3390/antibiotics12010129 |
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