Use of OPAT suggests inclusion in antibiotic stewardship program

Issue: October 2015

SAN DIEGO — The widespread use of pediatric outpatient parenteral antimicrobial therapy positions it as a primary candidate for an antibiotic stewardship program, according to data presented at ICAAC 2015.

“Outpatient parenteral antimicrobial therapy [OPAT] is an important venue for a pediatrics antibiotic stewardship program,” study researcher Gayatri Mirani, MD, from Tulane University School of Medicine, told Infectious Diseases in Children. “Our study at Children’s Hospital in New Orleans highlights a need for a standardized approach to OPAT to improve outcomes.”

Gayatri Mirani

To gauge OPAT usage, the researchers reviewed medical records of all patients discharged from the hospital between 2012 and 2013. Fifty-eight patients — including 40 admitted to orthopedic or general pediatric services with osteomyelitis — received OPAT at discharge. Most patients had hospital stays of 10 to 14 days, and OPAT was conducted for 4 weeks.

The most common bacteria isolate found in the study was Staphylococcus aureus. It was treated most often with clindamycin, ceftriaxone, vancomycin, cefazolin and nafcillin/oxacillin.

The researchers said pediatric infectious disease services was consulted in only 66% of OPAT cases. In 84% of them, therapy modification resulted in a change in antibiotic class. Thirteen study patients returned to the hospital because of adverse events. This included 11 readmitted within 1 month of discharge.

“Pediatric infectious diseases physicians play an integral role in recommending appropriate antibiotics and length of therapy, and managing adverse events related to prolonged antimicrobial therapy,” Mirani said. – by David Costill

Reference:

Mirani G, et al. Poster: S-927. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 17-21, 2015; San Diego.

Disclosure: The researchers report no relevant financial disclosures.