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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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.
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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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