Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis

Background: Patients with bronchiectasis often require hospitalisation for the administration of intravenous antibiotics for the management of acute exacerbations. Increasingly, Outpatient Parenteral Antibiotic Therapy (OPAT) services have become available as a potential alternative for domiciliary...

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Main Authors: Jacky Tu, Mohammed Al Harasi, Michael Pallin, Chris Daley, Benjamin A. Rogers, Paul T. King
Format: Article
Language:English
Published: Elsevier 2023-09-01
Series:Heliyon
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405844023071761
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author Jacky Tu
Mohammed Al Harasi
Michael Pallin
Chris Daley
Benjamin A. Rogers
Paul T. King
author_facet Jacky Tu
Mohammed Al Harasi
Michael Pallin
Chris Daley
Benjamin A. Rogers
Paul T. King
author_sort Jacky Tu
collection DOAJ
description Background: Patients with bronchiectasis often require hospitalisation for the administration of intravenous antibiotics for the management of acute exacerbations. Increasingly, Outpatient Parenteral Antibiotic Therapy (OPAT) services have become available as a potential alternative for domiciliary management. Aims: This study assessed outcomes in both cystic fibrosis (CF) and non-CF bronchiectasis patients who received OPAT for the management of an acute exacerbation of bronchiectasis. Methods: A retrospective study of consecutive subjects was done in both CF and non-CF groups in a large metropolitan Health Service in Australia from 2016 to 2022. Results: There were 51 episodes of care in the non-CF group (22 subjects) and 73 episodes in the CF group (13 subjects). The non-CF group were nearly all treated with once daily domiciliary intravenous (IV) ceftriaxone (49/51 episodes) for a duration of 9.1 ± 3.0 days (mean and standard deviation (SD)) via a peripherally inserted venous canula (84% of episodes). In contrast, the CF group generally received dual IV antibiotics (64% of episodes), with an average duration of 16.8 ± 6.3 days via central venous access (100%). In the non-CF group, the admission rate to hospital after 1 month was 9.6% and in the CF group was 0%. At 3 and 6 months the readmission rate for the non-CF group was 15.7% and 19.6% and CF group was 21.9% and 31.5%. There was a low rate of complications for the OPAT admissions (2% for the non-CF group and 7% for CF group). Conclusions: OPAT is a viable alternative for the management of bronchiectasis exacerbations.
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spelling doaj.art-95b3d65f1f9b4c9da149e6248ea3e7752023-10-01T06:02:03ZengElsevierHeliyon2405-84402023-09-0199e19968Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasisJacky Tu0Mohammed Al Harasi1Michael Pallin2Chris Daley3Benjamin A. Rogers4Paul T. King5Monash Lung, Sleep, Allergy and Immunology, Monash Medical Centre (MMC), Clayton, Melbourne, AustraliaMonash Lung, Sleep, Allergy and Immunology, Monash Medical Centre (MMC), Clayton, Melbourne, AustraliaMonash Lung, Sleep, Allergy and Immunology, Monash Medical Centre (MMC), Clayton, Melbourne, AustraliaMonash Lung, Sleep, Allergy and Immunology, Monash Medical Centre (MMC), Clayton, Melbourne, AustraliaSchool of Clinical Sciences, Monash University, Monash Health, Clayton, Melbourne, Australia; Monash Infectious Diseases, Monash Health, Clayton, Melbourne, AustraliaMonash Lung, Sleep, Allergy and Immunology, Monash Medical Centre (MMC), Clayton, Melbourne, Australia; School of Clinical Sciences, Monash University, Monash Health, Clayton, Melbourne, Australia; Corresponding author. Monash Lung, Sleep, Allergy and Immunology, 246 Clayton Rd Clayton 3168, Melbourne, Australia.Background: Patients with bronchiectasis often require hospitalisation for the administration of intravenous antibiotics for the management of acute exacerbations. Increasingly, Outpatient Parenteral Antibiotic Therapy (OPAT) services have become available as a potential alternative for domiciliary management. Aims: This study assessed outcomes in both cystic fibrosis (CF) and non-CF bronchiectasis patients who received OPAT for the management of an acute exacerbation of bronchiectasis. Methods: A retrospective study of consecutive subjects was done in both CF and non-CF groups in a large metropolitan Health Service in Australia from 2016 to 2022. Results: There were 51 episodes of care in the non-CF group (22 subjects) and 73 episodes in the CF group (13 subjects). The non-CF group were nearly all treated with once daily domiciliary intravenous (IV) ceftriaxone (49/51 episodes) for a duration of 9.1 ± 3.0 days (mean and standard deviation (SD)) via a peripherally inserted venous canula (84% of episodes). In contrast, the CF group generally received dual IV antibiotics (64% of episodes), with an average duration of 16.8 ± 6.3 days via central venous access (100%). In the non-CF group, the admission rate to hospital after 1 month was 9.6% and in the CF group was 0%. At 3 and 6 months the readmission rate for the non-CF group was 15.7% and 19.6% and CF group was 21.9% and 31.5%. There was a low rate of complications for the OPAT admissions (2% for the non-CF group and 7% for CF group). Conclusions: OPAT is a viable alternative for the management of bronchiectasis exacerbations.http://www.sciencedirect.com/science/article/pii/S2405844023071761BronchiectasisExacerbationsOutpatientParenteralAntibiotics
spellingShingle Jacky Tu
Mohammed Al Harasi
Michael Pallin
Chris Daley
Benjamin A. Rogers
Paul T. King
Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
Heliyon
Bronchiectasis
Exacerbations
Outpatient
Parenteral
Antibiotics
title Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title_full Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title_fullStr Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title_full_unstemmed Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title_short Outpatient parenteral antibiotic therapy (OPAT) for the management of bronchiectasis
title_sort outpatient parenteral antibiotic therapy opat for the management of bronchiectasis
topic Bronchiectasis
Exacerbations
Outpatient
Parenteral
Antibiotics
url http://www.sciencedirect.com/science/article/pii/S2405844023071761
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AT chrisdaley outpatientparenteralantibiotictherapyopatforthemanagementofbronchiectasis
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