Document Detail

Impact of mandatory inpatient infectious disease consultation on outpatient parenteral antibiotic therapy.
MedLine Citation:
PMID:  16103785     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Outpatient parenteral antibiotic therapy (OPAT) has had an important impact on infections historically requiring prolonged intravenous antibiotic treatment. Within the past decade, new antibiotics with oral/intravenous bioequivalence, plus recent data on infection management, have increased the potential role of the Infectious Disease (ID) consultant for OPAT. METHODS: We studied the impact of mandatory ID consultation on the use and outcomes of OPAT in patients initially hospitalized. The study was approved by the Institutional Review Board and the Executive Committee of the Medical Staff of Baystate Medical Center. Patients older than 18 years of age being considered for discharge to home on OPAT were identified, primarily through discharge planning. Formal ID consultation was performed to determine both need for OPAT and a variety of issues regarding antibiotic choice. Thirty-day telephone follow-up determined outcomes. Data regarding demographics, outcomes, and costs were analyzed. RESULTS: Forty-four patients received mandatory ID consultation, 39 (88.6%) of whom had some change in antibiotic recommendations. Seventeen (38.6%) were discharged on oral antibiotics, 1 (2.3%) had antibiotics discontinued, 13 (29.6%) had a change in parenteral antibiotic, 5 (11.4%) had a change in antibiotic dose, and 3 (6.8%) had a change in antibiotic duration. Follow-up demonstrated a single rehospitalization for unrelated issues. The total cost savings were 33,667.00 US dollars, approximately 760.00 US dollars per patient. Charges of consults were approximately 11,970.00 US dollars, still resulting in savings of close to 21,700.00 US dollars, or almost 500.00 US dollars per patient. CONCLUSIONS: Mandatory ID consultation resulted in substantial cost savings and excellent outcomes.
Rajendra Sharma; William Loomis; Richard B Brown
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  330     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-16     Completed Date:  2005-09-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  60-4     Citation Subset:  AIM; IM    
Infectious Disease Division, Department of Medicine, Baystate Medical Center, Boston, MA 01199, USA.
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MeSH Terms
Administration, Oral
Ambulatory Care / economics*
Anti-Bacterial Agents / administration & dosage*,  economics*,  therapeutic use
Bacterial Infections / drug therapy*
Injections, Intravenous
Treatment Outcome
Reg. No./Substance:
0/Anti-Bacterial Agents

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