A Review of Outpatient Parenteral Antimicrobial Therapy Practices and Experience at The Ottawa Hospital
Bibliographic record
Abstract
ABSTRACT Background: Outpatient parenteral antimicrobial therapy (OPAT) allows patients who require IV antimicrobials but whose condition is otherwise stable to receive therapy in the home. Objective: To describe the current practices and clinical outcomes of adult patients who received parenteral antimicrobial therapy after discharge from The Ottawa Hospital. Methods: The charts of 75 patients who received OPAT between November 1, 2003, and October 31, 2004, were reviewed to determine the indication for parenteral antibiotic therapy, the antimicrobial regimen selected, the extent of monitoring, the occurrence of complications, and the outcome of therapy. Results: Of the 75 patients whose charts were selected for review, 66 were included in the study. The most common infections treated were cellulitis (28 patients [42%]), osteomyelitis (8 patients [12%]), postsurgical wound infection (7 patients [11%]), and abscess and endocarditis (5 patients [8%] each). Cefazolin was the most commonly prescribed antimicrobial. Complications occurred in 19 (29%) of the 66 patients, and most of these related to the IV access. Overall, the majority of patients (56 or 85%) had a successful outcome. Conclusion: The majority of patients who received OPAT after discharge were treated successfully. However, the development of a formal multidisciplinary OPAT program could enhance quality of care through improvements in patient education, documentation, and monitoring. RESUME Historique : L’antibiotherapie parenterale externe (APE) permet au patient necessitant une antibiotherapie et dont l’etat de sante est par ailleurs stable, de recevoir le traitement a domicile. Objectif : Decrire les pratiques actuelles et les resultats cliniques de l’APE chez des patients adultes ayant recu leur conge de l’Hopital d’Ottawa. Methodes : Les dossiers de 75 patients qui ont recu une APE entre le 1er novembre 2003 et le 31 octobre 2004 ont ete examines afin de determiner l’indication sous-tendant l’antibiotherapie parenterale, le regime antibiotique choisi, la duree du suivi, la frequence des complications, et le resultat du traitement. Resultats : Parmi les 75 patients dont les dossiers ont ete selectionnes pour examen, 66 ont ete admis a l’etude. Les infections les plus courantes faisant l’objet d’une antibiotherapie etaient les suivantes : cellulite (28 patients [42 %]), osteomyelite (8 patients [12 %]), infection postchirurgicale d’une plaie (7 patients [11 %]), abces et endocardite (5 patients [8 %] chaque). La cefazoline etait l’antibiotique le plus prescrit. Des complications sont survenues chez 19 patients (29 %), la plupart liees a l’acces intraveineux. Dans l’ensemble, le traitement a reussi chez la majorite des patients (56 ou 85 %). Conclusions : Le traitement a reussi chez la majorite des patients qui ont recu une APE apres leur conge de l’hopital. Cependant, la mise au point d’un programme d’APE multidisciplinaire officiel pourrait accroitre la qualite des soins, grâce a des ameliorations au chapitre de l’education des patients, de la documentation et du suivi.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".