Table 1.
OPAT Patient Demographics and Factors Before and After the Intervention
| Patient Demographics | Before the Intervention (N = 73), No. (%) a |
After the Intervention (N = 355), No. (%) a |
P Value |
|---|---|---|---|
| Age, median y (IQR) | 52 (47–67) | 57 (43.5–60.5) | .023 |
| Sex, male | 45 (61.6) | 184 (51.8) | .126 |
| Antimicrobial indications | |||
| Bone and joint infection | 41 (56.2) | 133 (37.5) | .003 |
| CNS infection | 13 (17.8) | 34 (9.6) | .041 |
| Skin/soft-tissue infection | 6 (8.2) | 29 (8.2) | .989 |
| Genital/urinary tract infection | 2 (2.7) | 36 (10.1) | .043 |
| Intra-abdominal infection | 2 (2.7) | 34 (9.6) | .055 |
| Endocarditis | 1 (1.4) | 11 (3.1) | .700 |
| Pneumonia | 0 | 4 (1.1) | >.999 |
| Other | 8 (11) | 74 (20.8) | .051 |
| OPAT administration location | |||
| Home | 44 (60.3) | 190 (53.5) | .291 |
| Skilled nursing facility | 22 (30.1) | 57 (16.1) | .005 |
| Subacute rehabilitation facility | 7 (9.6) | 105 (29.6) | <.001 |
| Infusion center | 0 | 1 (0.3) | >.999 |
| Comorbidities | |||
| Myocardial infarction | 5 (6.8) | 4 (1.1) | .009 |
| Congestive heart failure | 6 (8.2) | 28 (7.9) | .924 |
| Peripheral vascular disease | 4 (5.5) | 27 (7.6) | .523 |
| Cerebrovascular disease | 4 (5.5) | 26 (7.3) | .574 |
| Dementia | 3 (4.1) | 9 (2.5) | .439 |
| Chronic pulmonary disease | 17 (23.3) | 42 (11.8) | .010 |
| Connective tissue disease | 5 (6.8) | 3 (0.8) | .002 |
| Peptic ulcer disease | 0 | 3 (0.8) | >.999 |
| Diabetes, without complications | 12 (16.4) | 52 (14.6) | .696 |
| Diabetes, with organ damage | 4 (5.5) | 67 (18.9) | .005 |
| Chronic kidney disease, moderate-to-severe | 15 (20.5) | 49 (13.8) | .141 |
| Hemiplegia or paraplegia | 7 (9.6) | 14 (3.9) | .067 |
| Leukemia | 2 (2.7) | 5 (1.4) | .341 |
| Malignant lymphoma | 2 (2.7) | 5 (1.4) | .341 |
| Solid tumor, nonmetastatic | 5 (6.8) | 34 (9.6) | .461 |
| Solid tumor, metastatic | 0 | 19 (5.4) | .055 |
| Liver disease, mild | 1 (1.4) | 12 (3.4) | .706 |
| Liver disease, moderate to severe | 3 (4.1) | 23 (6.5) | .595 |
| Acquired immunodeficiency syndrome | 5 (6.8) | 7 (2.0) | .038 |
| Charlson comorbidity index score, median (IQR) | 2 (0.5–3.5) | 3 (1.5–4.5) | <.001 |
| Hospital admission in the previous 12 mo | 36 (49.3) | 182 (51.3) | .761 |
| ICU admission during hospitalization | 31 (42.5) | 98 (27.6) | .012 |
| Insurance status | |||
| Government-funded insurance | 47 (64.4) | 259 (73.0) | .139 |
| Private insurance | 23 (31.5) | 79 (22.3) | .091 |
| No insurance | 3 (4.1) | 17 (4.8) | >.999 |
| Assigned primary care provider | 20 (27.4) | 221 (62.3) | <.001 |
| Microbiology | |||
| Positive culture | 48 (65.8) | 307 (86.5) | <.001 |
| ESBL | 2 (2.7) | 27 (7.6) | .198 |
| KPC | 1 (1.4) | 2 (0.6) | .430 |
| VRE | 2 (2.7) | 12 (3.4) | >.999 |
| MRSA | 14 (19.2) | 46 (13.0) | .163 |
| Any multidrug-resistant organism | 18 (24.7) | 84 (23.7) | .856 |
| Gram-positive pathogen | 39 (53.4) | 217 (61.1) | .222 |
| Gram-negative pathogen | 11 (15.1) | 120 (33.8) | .002 |
| Antimicrobial | |||
| β-lactam | 41 (56.2%) | 277 (78.0) | <.001 |
| Vancomycin | 39 (53.4%) | 110 (31.0) | <.001 |
| Fluoroquinolone | 1 (1.4%) | 3 (0.8) | .528 |
| Aminoglycoside | 0 | 2 (0.6) | >.999 |
| Macrolide | 0 | 3 (0.8) | >.999 |
| Daptomycin | 8 (11.0) | 19 (5.4) | .107 |
| Aztreonam | 1 (1.4) | 3 (0.8) | .528 |
| Linezolid | 1 (1.4) | 1 (0.3) | .312 |
| Clindamycin | 2 (2.7) | 0 | .029 |
| Colistin and polymyxin B | 2 (2.7) | 1 (0.3) | .077 |
| Antifungal | 1 (1.4) | 12 (3.4) | .706 |
| Antiviral | 0 | 3 (0.8) | >.999 |
| Other | 14 (19.2) | 14 (3.9) | <.001 |
| Planned duration of OPAT, median d (IQR) | 42 (32–52) | 36 (22.5–49.5) | .002 |
| In-house treatment duration, median d (IQR) | 8 (4.5–11.5) | 7 (4–10) | <.001 |
| Outpatient treatment duration, median d (IQR) | 30 (19–41) | 25 (12–38) | .068 |
Note. OPAT, outpatient parenteral antimicrobial therapy; IQR, interquartile range; CNS, central nervous system ICU, intensive care unit; ESBL, extended-spectrum β-lactamase–producing bacteria; KPC, Klebsiella pneumoniae carbapenemase–producing bacteria; VRE, vancomycin-resistant Enterococcus; MRSA, methicillin-resistant Staphylococcus aureus.
a
Units unless otherwise indicated.