Risk Factors for Hospital Readmission Following Outpatient Parenteral Antimicrobial Therapy (OPAT)

Area of Science:

• Infectious Diseases
• Clinical Pharmacy
• Health Services Research

Background:

• Outpatient parenteral antibiotic therapy (OPAT) aims to reduce inpatient stays.
• Understanding readmission factors in OPAT is key for improving patient care.
• Identifying modifiable risk factors can enhance OPAT practice.

Purpose of the Study:

• To identify characteristics associated with hospital readmission in adult patients receiving OPAT for non-urinary tract infections.
• To inform practice improvement strategies for reducing OPAT-related readmissions.

Main Methods:

• Retrospective analysis of 233 adult OPAT patients receiving infectious disease consultation for ≥14 days.
• Comparison of demographics, infection sites, microbiology, and prescribed antimicrobials between readmitted and non-readmitted patients.
• Statistical analysis to determine factors associated with readmission.

Main Results:

• 26% of OPAT patients were readmitted within 60 days, with 60% due to treatment failure.
• Obesity (BMI > 30 kg/m²) was significantly more frequent in readmitted patients (OR 3.6).
• Polymicrobial infections were more common in the readmitted group (OR 3.2).

Conclusions:

• Patients with obesity may require adjusted antibiotic dosing for adequate antimicrobial exposure.
• Standard dosing of certain antibiotics, like ceftriaxone, may be insufficient in obese patients.
• Further research is needed to optimize antibiotic dosing strategies for obese patients on OPAT.