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Outpatient parenteral antimicrobial therapy is safe and effective for the treatment of infective endocarditis: a retrospective cohort study
Author(s) -
Htin A. K. F.,
Friedman N. D.,
Hughes A.,
O'Brien D. P.,
Huffam S.,
Redden A.M.,
Athan E.
Publication year - 2013
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12081
Subject(s) - medicine , retrospective cohort study , endocarditis , infective endocarditis , surgery , antimicrobial , cohort , chemistry , organic chemistry
Background Outpatient parenteral antibiotic therapy has been shown to be efficacious, safe and cost‐effective for a variety of infections. The data from managing infective endocarditis ( IE ) with hospital in the home ( HITH ) are limited. We evaluated the safety and outcomes of patients with IE treated with HITH at our centre. Aims To evaluate the safety, efficacy and 1‐year outcomes of patients with IE treated under HITH at our centre over 9 years. Method A retrospective analysis of the clinical outcomes of all cases of IE treated with HITH at a tertiary referral centre was undertaken for patients treated between J une 2002 and J uly 2011 (9 years). Outcome measures included clinical cure, readmission rate, relapses and 1‐year mortality. Results Sixty‐eight cases of IE were treated with HITH over the study period, including 29 native valve infections, 24 prosthetic valve infections, 12 pacemaker lead infections, 1 defibrillator lead infection, 1 myocardial wall infection and 1 aortic graft infection. Thirteen cases had valve replacement surgery and 12 cases had removal of infected pacemaker leads. Staphylococcus aureus (18 cases), C oagulase‐negative staphylococcus (10 cases) and viridians‐group streptococcus (18 cases) were the most common pathogens. Median duration of antimicrobial therapy with HITH was 24 days (range 4 to 42 days). There were three readmissions during antimicrobial therapy with HITH . Two patients relapsed. There were two deaths and one patient was lost to follow up. One‐year survival was 96% (65/68). Conclusion Outpatient antimicrobial therapy with HITH is safe and effective in carefully selected cases of IE .