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Outpatient parenteral antibiotic therapy in non-cystic fibrosis lung transplant recipients: characteristics, efficacy and safety.
Bart, Forier; Veronique, Schaevers; Isabel, Spriet; Charlotte, Quintens; Stefanie, Desmet; Saskia, Bos; Pascal, Van Bleyenbergh; Natalie, Lorent; Laurens, De Sadeleer; Laurent, Godinas; Lieven, J Dupont; Robin, Vos.
Afiliación
  • Bart F; Leuven Transplant Center and Department of Respiratory Diseases, University Hospitals Leuven, Herestraat 49, Leuven, B-3000, Belgium.
  • Veronique S; Lung Transplant Team, Clinical Nurse Specialist, University Hospitals Leuven, Leuven, Belgium.
  • Isabel S; Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
  • Charlotte Q; Pharmacy Department, University Hospitals Leuven, Leuven, Belgium.
  • Stefanie D; Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
  • Saskia B; Pharmacy Department, University Hospitals Leuven, Leuven, Belgium.
  • Pascal VB; Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.
  • Natalie L; Leuven Transplant Center and Department of Respiratory Diseases, University Hospitals Leuven, Herestraat 49, Leuven, B-3000, Belgium.
  • Laurens S; Leuven Transplant Center and Department of Respiratory Diseases, University Hospitals Leuven, Herestraat 49, Leuven, B-3000, Belgium.
  • Laurent G; Leuven Transplant Center and Department of Respiratory Diseases, University Hospitals Leuven, Herestraat 49, Leuven, B-3000, Belgium.
  • Lieven JD; Department of CHROMETA, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium.
  • Robin V; Leuven Transplant Center and Department of Respiratory Diseases, University Hospitals Leuven, Herestraat 49, Leuven, B-3000, Belgium.
Eur J Clin Microbiol Infect Dis ; 2024 Aug 28.
Article en En | MEDLINE | ID: mdl-39196488
ABSTRACT

PURPOSE:

Bacterial isolation is associated with worse outcomes after lung transplantation (LTx), and successful bacterial eradication is shown to improve long-term survival and pulmonary function. Outpatient Parenteral Antibiotic Therapy (OPAT) may be an effective therapeutic modality for bacterial eradication post-LTx.

METHODS:

A single-center, retrospective analysis of OPAT characteristics, efficacy, safety, and costs in non-cystic fibrosis LTx recipients.

RESULTS:

A total of 156 OPAT courses (from June 2019 to December 2022) were evaluated in 108 distinct LTx recipients. OPAT mainly consisted of dual antibiotic therapy (69%) for pulmonary bacterial isolation (97%), mostly Pseudomonas aeruginosa (66%). Successful eradication at 3 months post-OPAT was achieved in 71%. Eradication rate was significantly higher in patients treated after the first post-operative year (79%), compared to patients within the first year (61%) (p = 0.017). Eradication rate was similar for multidrug resistance (eradication rate 61%) versus no multidrug resistance (74%) (p = 0.116). Spirometry remained stable at 90 days post-OPAT. A statistically significant, but clinically negligible, increase in serum creatinine at 90 days post-OPAT was observed (1.33 mg/dL vs. 1.39 mg/dL, p < 0.001), yet unrelated to the antibiotic regimen used. OPAT-related hospital admissions occurred in 13% and line-related adverse events in 6%. Median number of hospitalization days saved per OPAT-course was 10 days (range 2-92), accounting for a total of 1841 avoided admission days and an estimated net cost reduction of 47% per treatment course.

CONCLUSION:

OPAT is an effective and safe therapeutic modality for bacterial eradication post-LTx, associated with a significant reduction in hospitalization days and treatment costs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur J Clin Microbiol Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur J Clin Microbiol Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Bélgica Pais de publicación: Alemania