Effectiveness and safety of outpatient parenteral antimicrobial therapy in acute exacerbation of chronic obstructive pulmonary disease

Int J Clin Pract. 2017 Dec;71(12). doi: 10.1111/ijcp.13022. Epub 2017 Sep 26.

Abstract

Aim: We analysed the effectiveness and safety of outpatient parenteral antibiotic therapy (OPAT) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in patients admitted to home hospitalisation units (HHU).

Methods: Retrospective multicentre study of patients with AECOPD included in the Spanish OPAT Registry during 2 years period.

Results: Twenty-seven hospitals included 562 episodes in 361 patients diagnosed COPD GOLD III-IV. The most frequently isolated pathogen was Pseudomonas aeruginosa (38%) and the most frequently used antibiotic was piperacillin-tazobactam (20%). The effectiveness of OPAT defined as the rate of improvement or recovery was 93.4%. The safety of OPAT defined as no adverse drug events and no infectious or catheter-related complications was 89.3%. Moreover, the risk of hospital readmission was not greater in patients with AECOPD aged >80 years. No differences in the effectiveness or safety were observed when OPAT was administered by patients and/or caregivers.

Conclusion: Patients with AECOPD who require parenteral antimicrobial therapy can be managed effectively and safely in HHU, avoiding hospital stays, readmissions and complications.

Publication types

  • Multicenter Study

MeSH terms

  • Administration, Intravenous
  • Aged
  • Ambulatory Care
  • Anti-Infective Agents / therapeutic use*
  • Female
  • Home Care Services*
  • Humans
  • Male
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / microbiology
  • Spain

Substances

  • Anti-Infective Agents