A64 (P310) Outpatient parenteral antibiotic therapy (OPAT)

Published Date: 19th July 2016

Publication Authors: , Hardy KJ, Keigan S, Lewis A,

Aims 

To determine the benefits of OPAT in diabetes foot infections.

Methods

This was a retrospective study of consecutively initiated OPAT in patients with diabetes foot infections. Patients initiated on OPAT in a multidisciplinary diabetes foot clinic and inpatients discharged from a diabetes inpatient ward between April 2011 and May 2013 and referred to a community intravenous (IV) antibiotic team were included. Data were obtained by review of electronic case notes and data were collected prospectively by the community IV antibiotic team.

Results

There were 43 episodes of OPAT in 26 patients [mean age (SD) 62 (15.9) years] with diabetes foot infection. The indications for OPAT were osteomyelitis (53%) and soft tissue infection with foot ulceration (47%). IV antibiotics were administered via peripherally inserted central cannula line in 79%, peripheral cannula in 14% and via a midline in 7%. Common antibiotics used were meropenem (33%), teicoplanin (28%) and ceftriaxone (17.4%). The duration of OPAT was 36 (24.4) days. 81.4% (35/43) OPAT episodes resulted in improvement of the diabetes foot infection. Initiation of OPAT reduced length of inpatient stay in 44.2% (19/43) episodes and prevented hospital admission in 55.8% (24/43) episodes. This saved 1,817 hospital bed-days, resulting in a cost saving of 509,252 after accounting for the cost of antibiotics (31,703) and treatment monitoring (4,145).

Conclusions 

OPAT for diabetes foot infections is effective, reduces hospital admissions and length of stay and is cost effective.

Srinivas-Shankar, U; Keigan, S; Chiran, P; Lewis, A; O'Hanlon, S; Hodgkins, P; McGrail, P; Hardy, KJ. (2014).  A64 (P310) Outpatient parenteral antibiotic therapy (OPAT) in diabetes foot infection . Diabetic Medicine. 31 (Supplement S1), 24

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