Outpatient Parenteral Antibiotic Treatment vs Hospitalization for Infective Endocarditis: Validation of the OPAT-GAMES Criteria

Autor:	Juan M, Pericàs, Jaume, Llopis, Patricia, Muñoz, Víctor, González-Ramallo, M Eugenia, García-Leoni, Arístides, de Alarcón, Rafael, Luque, M Carmen, Fariñas, Miguel Á, Goenaga, Marta, Hernández-Meneses, David, Nicolás, Antonio, Ramos-Martínez, M Ángeles, Rodríguez-Esteban, Aroa, Villoslada-Gelabert, José M, Miró, Manuel, Taurón
Rok vydání:	2022
Předmět:	Infectious Diseases Endocarditis Oncology recurrences Antibiotics infective endocarditis readmission Mortalitat Antibiòtics outpatient parenteral antibiotic treatment mortality
Zdroj:	Open forum infectious diseases. 9(9)
ISSN:	2328-8957
Popis:	Background Outpatient parenteral antibiotic treatment (OPAT) programs are increasingly used to manage infective endocarditis (IE), but current criteria for indicating OPAT are markedly conservative. We aimed to investigate whether more liberal criteria for indicating OPAT in IE can be safely used. Methods This was a prospective multicenter nationwide cohort study (2008–2018). Rates of readmission, recurrences, and 1-year mortality were compared between hospital-based antibiotic treatment (HBAT) and OPAT. Risk factors for readmission and mortality in OPAT patients were investigated by logistic regression. Patients did not fulfill OPAT-GAMES (Grupos de Apoyo al Manejo de la Endocarditis en ESpaña) criteria if they had any of the following: cirrhosis, severe central nervous system emboli, undrained abscesses, severe conditions requiring cardiac surgery in nonoperable patients, severe postsurgical complications, highly difficult-to-treat microorganisms, or intravenous drug use. Results A total of 2279 HBAT patients and 1268 OPAT patients were included. Among OPAT patients, 307 (24.2%) did not fulfill OPAT-GAMES criteria. Overall, OPAT patients presented higher rates of readmission than HBAT patients (18.2% vs 14.4%; P = .004), but no significant differences were found in the propensity analysis. Patients not fulfilling OPAT-GAMES criteria presented significantly higher rates of readmission than HBAT and OPAT-GAMES (23.8%, 14.4%, 16.4%; P Conclusions OPAT-GAMES criteria allow identification of IE patients at higher risk of long-term complications to whom OPAT cannot be safely administered.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::57d3dccc9b63e672f4ede6e912b0f9a9 https://pubmed.ncbi.nlm.nih.gov/36172059 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
Nepřihlášeným uživatelům se plný text nezobrazuje	K zobrazení výsledku je třeba se přihlásit.