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Int J Clin Pract. 2017 Dec;71(12). doi: 10.1111/ijcp.13022. Epub 2017 Sep 26.

Effectiveness and safety of outpatient parenteral antimicrobial therapy in acute exacerbation of chronic obstructive pulmonary disease.

Author information

1
Home Hospitalization Unit and Department of Respiratory Medicine, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain.
2
Home Hospitalization Unit, Hospital Torrejón Ardoz, Madrid, Spain.
3
Home Hospitalization Unit, Parc Tauli Hospital Universitari, Sabadell, Spain.
4
Department of Procesos Transversales y Alianzas, Institut Catala de la Salut, Barcelona, Spain.
5
Department of Hospital Admissions, Hospital de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria, Spain.
6
Home Hospitalization Unit, Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain.
7
Departament of Pneumology, Consorcio Hospital General de Valencia, Valencia, Spain.
8
Department of Pneumology, Hospital Universitario San Juan de Alicante, Alicante, Spain.

Abstract

AIM:

We analysed the effectiveness and safety of outpatient parenteral antibiotic therapy (OPAT) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in patients admitted to home hospitalisation units (HHU).

METHODS:

Retrospective multicentre study of patients with AECOPD included in the Spanish OPAT Registry during 2 years period.

RESULTS:

Twenty-seven hospitals included 562 episodes in 361 patients diagnosed COPD GOLD III-IV. The most frequently isolated pathogen was Pseudomonas aeruginosa (38%) and the most frequently used antibiotic was piperacillin-tazobactam (20%). The effectiveness of OPAT defined as the rate of improvement or recovery was 93.4%. The safety of OPAT defined as no adverse drug events and no infectious or catheter-related complications was 89.3%. Moreover, the risk of hospital readmission was not greater in patients with AECOPD aged >80 years. No differences in the effectiveness or safety were observed when OPAT was administered by patients and/or caregivers.

CONCLUSION:

Patients with AECOPD who require parenteral antimicrobial therapy can be managed effectively and safely in HHU, avoiding hospital stays, readmissions and complications.

PMID:
28949430
DOI:
10.1111/ijcp.13022
[Indexed for MEDLINE]

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