Date of Award

2019

Degree Type

Thesis

Degree Name

Honors Thesis

Department

Pharmacy

First Advisor

Jessica Wilhoite

Abstract

Introduction: Outpatient parenteral antimicrobial therapy (OPAT) has gained popularity since its first description in 1974. At Community Health Network (CHN), the OPAT clinic was developed three years ago by an ambulatory care clinical pharmacist and includes pharmacist driven monitoring for all patients receiving OPAT. The pharmacist ensures labs are drawn weekly to assess for renal or hepatic function changes, medication levels are drawn and adjusted as needed, and repeat labs and levels are ordered to continue assessing therapy. There have not been any studies to date to investigate CHN’s OPAT program both demographically and clinically.

Objectives: The primary objective of this study was to qualitatively determine the number of patients, types of infections, source organism, antibiotics utilized, duration of therapy, adverse effects, and number and types of interventions made to therapy by the OPAT clinical pharmacist.

Methods: This study was conducted via retrospective chart analysis and included both demographic and clinical information such as infection type, source organism(s), antibiotic, duration of therapy, adverse effects, and successful completion of OPAT regimen. Information regarding number and type of pharmacist intervention were also recorded. Patients who received OPAT from January 2017 to January 2018 were included in the study.

Results: 226 patients were included in the study. Over ten different types of infections were identified with osteomyelitis being most common (n=65). The majority of infections were attributed to Staphylococcus aureus both methicillin sensitive and methicillin resistant organisms with another large portion deemed culture negative. Antibiotics used in the OPAT program primarily consisted of vancomycin (n=67), ceftriaxone (n=60), and cefazolin (n=52). The mean total duration of treatment was 42.7 days and a mean of 33.45 of those occurred via OPAT once the patient was discharged. The pharmacist made a total of 138 interventions equaling about 0.6 interventions per patient. 93.4% of patients included successfully completed the OPAT program.

Conclusion: CHN’s OPAT program involved a wide variety of patients with diverse infections and antibiotic therapy. This study helped to successfully determine the demographic and clinical information from January 2017 to January 2018. High rates of success in CHN’s OPAT program provides support for continued use in the future with pharmacist involvement.

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