Comparative outcomes of β-lactam antibiotics in outpatient parenteral antibiotic therapy: treatment success, readmissions and antibiotic switches

摘要: OBJECTIVES β-Lactam antibiotics are commonly used in outpatient parenteral antimicrobial therapy (OPAT), but data regarding outcomes of long-term limited. The purpose this study was to compare treatment success, readmission and antibiotic switch rates patients treated with β-lactam as OPAT. METHODS We carried out a retrospective review all patients, discharged from Tufts Medical Center cefazolin, ceftriaxone, ertapenem or oxacillin, between January 2009 June 2013. A competing risks analysis the cumulative incidence first occurrence 30 day for each drug. RESULTS Four hundred were identified (cefazolin n = 38, ceftriaxone n = 104, n = 128 oxacillin n = 130). Baseline demographics similar. Treatment success higher 61%, 81%, 73% 58%; P < 0.001). Thirty-day all-cause readmissions similar 21%, 14%, 20% 15%; P = 0.46). In 400 OPAT courses, 37 50 switches accomplished without readmission. Adverse drug events (ADEs) most common reason (31/37, 84%). ADE rate group 2.0 versus 1.5 2.9 8.4 per 1000 days; CONCLUSIONS is effective, adverse more frequent use. Clinicians should be cognizant risk ADEs value lies reducing patient morbidity by managing preventing clinical failures.