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Monitoring of Outpatient Parenteral Antimicrobial Therapy and Implementation of Clinical Pharmacy Services at a Community Hospital Infusion Unit


, : Monitoring of Outpatient Parenteral Antimicrobial Therapy and Implementation of Clinical Pharmacy Services at a Community Hospital Infusion Unit. Journal of Pharmacy Practice 28(5): 462-468

In 2004, the Infectious Diseases Society of America (IDSA) published monitoring guidelines for outpatient parenteral antimicrobial therapy (OPAT), but no assessment of their utilization has been reported. We evaluated adherence to these recommendations by physicians at infusion centers and then piloted a program of supervision of monitoring by pharmacists. Phase I: We performed a retrospective case-control study of patients who received OPAT over 1 year at 2 hospital infusion centers. Controls were patients treated by an infectious diseases (ID) physician, and cases were those without an ID physician. Patients were excluded if they received fewer than 3 days of OPAT. Clinical pharmacy monitoring services were then implemented for patients on OPAT prescribed by non-ID physicians at 1 hospital's infusion unit. Two outcomes were measured: adherence to guidelines on monitoring and attainment of goal vancomycin and aminoglycoside serum concentrations when appropriate. The results for non-ID physicians were compared to both ID physicians and subsequently a pharmacist. Ninety-nine patients were included in the retrospective study. Compared with patients who had ID physician supervision, the non-ID physicians who prescribed OPAT for 39 patients had lower adherence to monitoring recommendations (35.9% vs 68.3%, P = .003). No difference could be detected in achievement of goal vancomycin and aminoglycoside serum concentrations for the 14 cases and 19 controls requiring therapeutic drug monitoring (57.1% vs 68.4%, respectively, P = .765). Seven patients were enrolled in the study after pharmacy monitoring was implemented. Adherence to monitoring recommendations for these patients was significantly improved compared to the prior patients who lacked ID physician supervision (35.9% vs 100%, P = .0065). Non-ID physicians are less likely to monitor OPAT according to the IDSA guidelines than ID physicians; however, pharmacist oversight improves adherence to recommendations. Further studies of monitoring of OPAT by pharmacists should investigate the impact of pharmacist involvement on prevention of adverse events and hospital readmissions.

US$19.90

PMID: 25107418

DOI: 10.1177/0897190014544786


Other references

Thatcher F.S., 1973: Microbiological problems in meats and meat products. U N E S C O And W H O Global Impacts Of Applied Microbiology 4th International Conference Impactos Globais Da Microbiologia Aplicada Incidences Mondiales De La Microbiologie Appliquee Impactos Globales De La Microbiologia Aplicada Sao Paulo, Brazil, July 23-28, 35p Unipub, Inc : P O Box 433, New York, N Y , U S A

Nass, M.; Weissbrich, B.; Huber, M.; Schneider, E.Marion.; Weiss, M., 2013: BK viremia in critically ill surgical patients with hemorrhagic or septic shock. Infections with polyomavirus BK virus (BKV) are a common cause of renal dysfunction after renal transplantation and may also be harmful in surgical patients with shock. The aim of the present study was to determine the frequency of BKV viremia in...

Kleinschmidt, G., 1958: Demonstration of morphine in Papaver setigerum. Archiv der Pharmazie und Berichte der Deutschen Pharmazeutischen Gesellschaft 291/63(2): 109-111

McNair, A.; Moran, C.; McGrath, E.; Naqvi, S.; Connolly, C.; McKenna, V.; Kropmans, T., 2012: How we implemented an integrated professionalism curriculum to 2nd year medical students at the National University of Ireland Galway Medical School, with examples from students' final output. Since the introduction of professionalism in medical curricula worldwide, little evidence has been published to exemplify good educational practice. The Medical school at the National University of Ireland Galway teaches professionalism in an inte...

Aoe, K.; Hiraki, A.; Murakami, T.; Toyooka, S.; Shivapurkar, N.; Gazdar, A.F.; Sueoka, N.; Taguchi, K.; Kamei, T.; Takeyama, H.; Sugi, K.; Kishimoto, T., 2006: Infrequent existence of simian virus 40 large T antigen DNA in malignant mesothelioma in Japan. Malignant mesothelioma is the most common primary pleural neoplasm. Association of simian virus 40 (SV40) with malignant mesothelioma has been reported, suggesting that SV40 plays an important role in the origin of a subset of these tumors. Howeve...

Hoff, H.; Hofmann, G., 1968: Phase-specific therapy of psychic disturbances: biologic, psychotherapeutic and sociodynamic aspects. Psychiatry Digest 29(6): 11-14

Bogomolov, B.P.; Deviatkin, A.V.; Mitiushina, S.A.; Mol'kova, T.N., 2007: Acute myocarditis caused by ECHO virus. Enteroviral infection is characterized by clinical polymorphism. One of its clinical manifestation is myocarditis, which is usually caused by Coxsackie virus. ECHO viruses cause the disease mostly in childhood. The article presents a case of enter...

Liang, C-Yi.; Liu, Y-Chun.; Shieh, T-Yu.; Lin, J-Rong.; Tseng, Y-Chun.; Teng, A.Yen-Tung., 2016: Experience of Early Childhood Caries May Positively Correlate with Psychomotor Development. To examine the as yet unknown relationship between dental caries and the child's psychomotor development. A cross-sectional study was designed by screening the kindergartens from urban areas of two cities in southern Taiwan. Besides the perso...

Frandin, K.; Grimby, G., 1994: Assessment of physical activity, fitness and performance in 76-year-olds. In a population study comprising 588 76-year-olds, the level of physical activity and physical performance, as well as associations between the variables included, was investigated. Men were significantly more active than women unless household ac...

Mezhlum' yan, L.G.; Redina, E.F.; Yuldashev, P.K., 1997: Functions of inhibitors of proteolytic enzymes in plants. Information on proteins of plant origin which act as proteinase inhibitors, published between 1977 and 1994, is discussed with reference to the regulatory function of proteinase inhibitors (including the regulation of proteolysis of reserve protei...