Table 5.
Author | City | Healthcare system | Number of patients | OPAT venue | Main infections diagnoses | Main drugs used in OPAT | Conclusions of the study |
---|---|---|---|---|---|---|---|
Oliveira et al. 9 | São Paulo | SUS | 116 | Primary care facilities, day hospital | Chronic osteomyelitis, acute osteomyelitis, soft tissue infection | Teicoplanin, ertapenem, tigecycline | 450 primary care health professionals were trained to manipulate catheters and monitor patients. Positive clinical outcomes, with only 3 OPAT-related adverse events. In 1 year, it was possible to redirect 11,698 bed-days to patients in need of orthopedic hospitalization |
Psaltikidis et al. 14 | Campinas | SUS | 39 | Day hospital | Central nervous system syphilis, urinary tract infection, osteomyelitis | Ceftriaxone, amikacin, meropenem | Favorable clinical outcomes, with improved perception of quality of life by patients. OPAT allowed 1112 days less hospitalization and proved to be cost-effective compared with inpatient treatment |
Cassettari et al. 11 | São Paulo | PHI | 441 | Home care | Urinary tract infection, pulmonary infection, surgical site infection | Teicoplanin, ceftriaxone, meropenem | Low rate of treatment failure (0.4%). Outpatient stewardship program was effective and safe |
Salles et al. 12 | Santo André | PHI | 276 | Home care, outpatient clinics | Pneumonia, urinary tract infection | Ceftriaxone | Palliative care and not having had a postdischarge physician office visit within the first 30 days after inclusion in the OPAT program were risk factors for hospital readmission and mortality |
Loesch et al. 10 | Curitiba | SUS | 291 | Day hospital, home care | Urinary tract infection, pneumonia, osteomyelitis | Not mentioned | OPAT allowed for significant cost savings and reduction in length of stay. OPAT also reduced risk. OPAT also reduced the risk of contamination of patients with multidrug-resistant bacteria |
Freitas et al. 13 | Fortaleza | SUS | 23 | Day hospital | Urinary tract infection, bloodstream infection | Ertapenem (only) | 95.65% clinical cure among patients with liver and kidney transplants and infections with Gram-negative bacilli susceptible only to carbapenems. Cost of treatment in OPAT was higher than that of hospitalization due to the high price of ertapenem (reference drug) compared with meropenem (generic drug) |
OPAT, outpatient parenteral antimicrobial therapy; PHI, private health insurance; SUS, Sistema Único de Saúde (Brazilian public health system).