Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program
Vancomycin is commonly used in outpatient parenteral antimicrobial therapy (OPAT) of Gram-positive infections. Therapeutic drug monitoring and adverse event monitoring pose a challenge. Outcome data of vancomycin in OPAT (vOPAT) are limited. The study aim was to report the safety and efficacy of a s...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/5/702 |
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| author | Lore Thijs Charlotte Quintens Lotte Vander Elst Paul De Munter Melissa Depypere Willem-Jan Metsemakers Georges Vles Astrid Liesenborghs Jens Neefs Willy E. Peetermans Isabel Spriet |
| author_facet | Lore Thijs Charlotte Quintens Lotte Vander Elst Paul De Munter Melissa Depypere Willem-Jan Metsemakers Georges Vles Astrid Liesenborghs Jens Neefs Willy E. Peetermans Isabel Spriet |
| author_sort | Lore Thijs |
| collection | DOAJ |
| description | Vancomycin is commonly used in outpatient parenteral antimicrobial therapy (OPAT) of Gram-positive infections. Therapeutic drug monitoring and adverse event monitoring pose a challenge. Outcome data of vancomycin in OPAT (vOPAT) are limited. The study aim was to report the safety and efficacy of a structured vOPAT program implemented in the University Hospitals Leuven. The program provides continuous elastomeric infusion of vancomycin at home with biweekly follow-up at the outpatient clinic. Demographics, clinical, biochemical and treatment parameters, target attainment parameters and clinical outcomes were recorded. An e-survey was conducted to assess patient satisfaction. Thirty-five vOPAT episodes in 32 patients were included. During 206 follow-up consultations, 203 plasma concentration measurements were registered with a median vancomycin plasma concentration of 22.5 mg/L (range 6.6–32.0). The majority of concentrations (68.5%) were within the therapeutic range (20.0–25.0 mg/L). Adverse event rates, including drug- (5.7%) and catheter-related (5.7%) events, were low. For 32 vOPAT episodes, a clinical cure rate of 100% was observed. All patients who completed the e-survey were satisfied with their vOPAT course. These findings show that a structured vOPAT program with rigorous follow-up provides safe and effective ambulatory treatment of patients with vancomycin in continuous infusion. |
| first_indexed | 2024-03-10T03:27:37Z |
| format | Article |
| id | doaj.art-bcbe889edb914f16b4904669287b4faf |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-10T03:27:37Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-bcbe889edb914f16b4904669287b4faf2023-11-23T09:49:56ZengMDPI AGAntibiotics2079-63822022-05-0111570210.3390/antibiotics11050702Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy ProgramLore Thijs0Charlotte Quintens1Lotte Vander Elst2Paul De Munter3Melissa Depypere4Willem-Jan Metsemakers5Georges Vles6Astrid Liesenborghs7Jens Neefs8Willy E. Peetermans9Isabel Spriet10Pharmacy Department, University Hospitals Leuven, 3000 Leuven, BelgiumPharmacy Department, University Hospitals Leuven, 3000 Leuven, BelgiumPharmacy Department, University Hospitals Leuven, 3000 Leuven, BelgiumDepartment of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, BelgiumClinical Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, BelgiumDepartment of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, BelgiumDepartment of Orthopaedics, University Hospitals Leuven, 3000 Leuven, BelgiumPharmacy Department, University Hospitals Leuven, 3000 Leuven, BelgiumPharmacy Department, University Hospitals Leuven, 3000 Leuven, BelgiumDepartment of Microbiology, Immunology and Transplantation, KU Leuven, 3000 Leuven, BelgiumPharmacy Department, University Hospitals Leuven, 3000 Leuven, BelgiumVancomycin is commonly used in outpatient parenteral antimicrobial therapy (OPAT) of Gram-positive infections. Therapeutic drug monitoring and adverse event monitoring pose a challenge. Outcome data of vancomycin in OPAT (vOPAT) are limited. The study aim was to report the safety and efficacy of a structured vOPAT program implemented in the University Hospitals Leuven. The program provides continuous elastomeric infusion of vancomycin at home with biweekly follow-up at the outpatient clinic. Demographics, clinical, biochemical and treatment parameters, target attainment parameters and clinical outcomes were recorded. An e-survey was conducted to assess patient satisfaction. Thirty-five vOPAT episodes in 32 patients were included. During 206 follow-up consultations, 203 plasma concentration measurements were registered with a median vancomycin plasma concentration of 22.5 mg/L (range 6.6–32.0). The majority of concentrations (68.5%) were within the therapeutic range (20.0–25.0 mg/L). Adverse event rates, including drug- (5.7%) and catheter-related (5.7%) events, were low. For 32 vOPAT episodes, a clinical cure rate of 100% was observed. All patients who completed the e-survey were satisfied with their vOPAT course. These findings show that a structured vOPAT program with rigorous follow-up provides safe and effective ambulatory treatment of patients with vancomycin in continuous infusion.https://www.mdpi.com/2079-6382/11/5/702OPAT at homevancomycincontinuous infusionelastomeric pumptherapeutic drug monitoringadverse event monitoring |
| spellingShingle | Lore Thijs Charlotte Quintens Lotte Vander Elst Paul De Munter Melissa Depypere Willem-Jan Metsemakers Georges Vles Astrid Liesenborghs Jens Neefs Willy E. Peetermans Isabel Spriet Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program Antibiotics OPAT at home vancomycin continuous infusion elastomeric pump therapeutic drug monitoring adverse event monitoring |
| title | Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program |
| title_full | Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program |
| title_fullStr | Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program |
| title_full_unstemmed | Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program |
| title_short | Clinical Efficacy and Safety of Vancomycin Continuous Infusion in Patients Treated at Home in an Outpatient Parenteral Antimicrobial Therapy Program |
| title_sort | clinical efficacy and safety of vancomycin continuous infusion in patients treated at home in an outpatient parenteral antimicrobial therapy program |
| topic | OPAT at home vancomycin continuous infusion elastomeric pump therapeutic drug monitoring adverse event monitoring |
| url | https://www.mdpi.com/2079-6382/11/5/702 |
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