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Conventional hospitalization versus sequential outpatient parenteral antibiotic therapy for Staphylococcus aureus bacteremia: post-hoc analysis of a multicenter observational cohort

Authors :
Universidad de Sevilla. Instituto de Biomedicina de Sevilla (IBIS)
Universidad de Sevilla. Departamento de Medicina
Castillo-Fernández, Nerea
Martínez Pérez-Crespo, Pedro María
Salamanca-Rivera, Elena
Herrera-Hidalgo, Laura
Alarcón, Arístides de
Navarro-Amuedo, María Dolores
Gutiérrez Gutiérrez, Belén
Rodríguez-Baño, Jesús
López-Cortes, Luis Eduardo
Universidad de Sevilla. Instituto de Biomedicina de Sevilla (IBIS)
Universidad de Sevilla. Departamento de Medicina
Castillo-Fernández, Nerea
Martínez Pérez-Crespo, Pedro María
Salamanca-Rivera, Elena
Herrera-Hidalgo, Laura
Alarcón, Arístides de
Navarro-Amuedo, María Dolores
Gutiérrez Gutiérrez, Belén
Rodríguez-Baño, Jesús
López-Cortes, Luis Eduardo
Publication Year :
2023

Abstract

It is not known whether sequential outpatient parenteral antimicrobial (OPAT) is as safe and effective as conventional hospitalization in patients with S. aureus bacteremia (SAB). A post-hoc analysis of the comparative effectiveness of conventional hospitalization versus sequential OPAT was performed in two prospective Spanish cohorts of patients with S. aureus bacteremia. The PROBAC cohort is a national, multicenter, prospective observational cohort of patients diagnosed in 22 Spanish hospitals between October 2016 and March 2017. The DOMUS OPAT cohort is a prospective observational cohort including patients from two university hospitals in Seville, Spain from 2012 to 2021. Multivariate regression was performed, including a propensity score (PS) for receiving OPAT, stratified analysis according to PS quartiles, and matched pair analyses based on PS. Four hundred and thirteen patients were included in the analysis: 150 in sequential OPAT and 263 in the full hospitalization therapy group. In multivariate analysis, including PS and center effect as covariates, 60-day treatment failure was lower in the OPAT group than in the full hospitalization group (p < 0.001; OR 0.275, 95%CI 0.129–0.584). In the PS-based matched analyses, sequential treatment under OPAT was not associated with higher 60-day treatment failure (p = 0.253; adjusted OR 0.660; % CI 0.324–1.345). OPAT is a safe and effective alternative to conventional in-patient therapy for completion of treatment in well-selected patients with SAB, mainly those associated with a low-risk source and without end-stage kidney disease.

Details

Database :
OAIster
Notes :
English
Publication Type :
Electronic Resource
Accession number :
edsoai.on1428430118
Document Type :
Electronic Resource