Clinical outcomes of a veterans affairs outpatient antimicrobial treatment program

Shahrzad Mohammadi, Kimberly Mackay, Thomas Ward, Graeme N. Forrest

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVES: The outpatient parenteral antibiotic therapy (OPAT) program of the Portland Veterans Affairs Medical Center (PVAMC), which has a self-administration model, is staffed by visiting nurses from a specialist infusion company. This study evaluates the clinical outcomes of these patients. METHODS: This study was a retrospective chart review of 262 patients at PVAMC who had received OPAT between 2007 and 2009. Patients were included only if they received ongoing care at PVAMC. The data collected included conditions and organisms being treated and types and durations of antibiotics used. Clinical cure was defined as documented cure at the end of treatment and 90 days post-OPAT. RESULTS: One hundred ninety patients of 262 were analyzed. The mean age was 63.2 years. Diabetes was the main comorbid factor (17%). The most common indications for OPAT were osteomyelitis (38%), urinary tract infection (23%), and skin and soft tissue infection (12.6%). Mixed bacterial culture (26%) and Staphylococcus aureus (31%) were the most common organisms treated. Vancomycin was the most frequently used antibiotic (26%) followed by ceftriaxone (12%). The median duration of OPAT was 30 days. The rate of clinical cure at end of treatment observed for all infections treated was 78%, which then decreased to 58% at 90 days post-OPAT (P <0.001). Patients with diabetes and osteomyelitis had an increased risk of relapse at 90 days post-OPAT on multivariate analysis (P = 0.025). CONCLUSIONS: An OPAT program using a self-administration model treating patients who were military veterans had successful outcomes. Patients with diabetes and osteomyelitis had worse clinical outcomes 90 days after the completion of OPAT therapy.

Original languageEnglish (US)
Pages (from-to)345-349
Number of pages5
JournalSouthern Medical Journal
Volume106
Issue number6
DOIs
StatePublished - Jun 2013
Externally publishedYes

Fingerprint

Veterans
Outpatients
Anti-Bacterial Agents
Osteomyelitis
Therapeutics
Self Administration
Soft Tissue Infections
Community Health Nurses
Ceftriaxone
Vancomycin
Urinary Tract Infections
Staphylococcus aureus
Multivariate Analysis
Recurrence

Keywords

  • Diabetes mellitus
  • Osteomyelitis
  • Outpatient parenteral antibiotic therapy
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Clinical outcomes of a veterans affairs outpatient antimicrobial treatment program. / Mohammadi, Shahrzad; Mackay, Kimberly; Ward, Thomas; Forrest, Graeme N.

In: Southern Medical Journal, Vol. 106, No. 6, 06.2013, p. 345-349.

Research output: Contribution to journalArticle

Mohammadi, Shahrzad ; Mackay, Kimberly ; Ward, Thomas ; Forrest, Graeme N. / Clinical outcomes of a veterans affairs outpatient antimicrobial treatment program. In: Southern Medical Journal. 2013 ; Vol. 106, No. 6. pp. 345-349.
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