Safety and efficacy of an outpatient parenteral antimicrobial therapy program at a tertiary hospital in Belgium: a monocentric retrospective observational study.

[en] OBJECTIVES: Outpatient parenteral antimicrobial therapy (OPAT) offers a safe, effective, and resource-sparing alternative to inpatient treatment for various infections. Despite its widespread adoption globally, the implementation of OPAT programs in Belgium has been limited until recently. This study evaluates the safety, efficacy and healthcare impact of an OPAT program at a university hospital in Liège, Belgium.
METHODS: We conducted a retrospective observational study at a 1038-bed tertiary teaching hospital, including patients who received OPAT between January 2018 and December 2021. Electronic medical records were reviewed for demographics, diagnoses, treatment regimens, adverse events, and outcomes. Potential risk factors for adverse events and treatment failure were investigated.
RESULTS: A total of 352 OPAT episodes in 327 patients were analyzed. The most frequent indications were bloodstream infections (29.8%) and urinary tract infections (27.8%). Continuous antibiotic administration was used in 60.6% of cases, with a median OPAT duration of 16 days. Clinical cure was achieved in 86.4% of patients. Unplanned readmission linked to OPAT, infection-related death, drug-related adverse events, and line-related complications occurred in 8.2%, 1.1%, 5.1%, and 4.2% of episodes, respectively. Risk factors for adverse outcomes were identified, including cirrhosis, hematological malignancies, osteoarticular infections, chronic renal failure, and the use of specific antibiotics. The program avoided a mean of 1692 hospitalization days per year, underscoring its significant healthcare impact.
CONCLUSION: This study highlights the favorable outcomes and safety profile of the OPAT program at our tertiary teaching hospital. Tailored interventions and careful antibiotic selection are warranted for specific patient groups.