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Outpatient parenteral antimicrobial therapy-treated bone and joint infections in a tropical setting

H A White1, J S Davis, P Kittler

  • 1Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia. helenawhite@doctors.org.uk

Internal Medicine Journal
|December 17, 2009
PubMed
Abstract

Insights

Outpatient parenteral antimicrobial therapy (OPAT) is effective for osteoarticular infections in tropical Australia. This approach successfully treated diverse patient groups, including those in remote areas.

Area of Science:

  • Infectious Diseases
  • Tropical Medicine
  • Public Health

Background:

  • Osteoarticular infections are a common reason for outpatient parenteral antimicrobial therapy (OPAT).
  • Tropical Australia presents unique challenges for managing these infections due to climate, geography, and prevalent diseases like melioidosis and MRSA.
  • Royal Darwin Hospital's Hospital in the Home service was evaluated for managing bone and joint infections.

Purpose of the Study:

  • To evaluate the feasibility and effectiveness of OPAT for osteoarticular infections in a tropical Australian setting.
  • To assess treatment outcomes for patients managed by the Royal Darwin Hospital's Hospital in the Home service.
  • To determine the suitability of OPAT for indigenous populations and those in remote communities.

Main Methods:

  • Retrospective analysis of therapeutic outcomes for patients treated between January 2006 and September 2007.
  • Inclusion of patients with osteoarticular infections managed via the Hospital in the Home service.
  • Data collection on patient demographics, treatment duration, location of care, and clinical success.

Main Results:

  • Fifty-five patients were treated, with 21 (38%) indigenous Australians and 18 (33%) from remote communities.
  • Clinical success at the end of therapy was 84%, with no significant difference between indigenous and non-indigenous patients.
  • OPAT facilitated significant hospital bed-day savings (1307 bed-days) through extended community and remote-clinic-based treatment.

Conclusions:

  • Outpatient parenteral antimicrobial therapy (OPAT) is a feasible and effective treatment for osteoarticular infections in tropical environments.
  • OPAT can be successfully extended to indigenous patients and those residing in remote areas.
  • Innovative models, including self-care units and remote clinic administration, enhance OPAT delivery in challenging settings.

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