Evaluation of the effectiveness, safety and costs of outpatient intravenous antimicrobial treatment (OPAT) vs hospitalized in urinary infection in pediatrics - Abstract

BACKGROUND: Childrens hospitalization for intravenous antibiotic treatment has been replaced in developed countries and in some Chilean centers to outpatient intravenous therapy (OPAT).

AIM: To compare the effectiveness, safety and cost of OPAT versus inpatient care.

PATIENTS AND METHODS: Prospective cohort study in children (2 months-5 years) with febrile urinary tract infection (UTI) attended at two public Chilean hospitals: outpatient cohort and inpatient cohort. Between November of 2009-2010, 111 children were enrolled in OPAT and between January 2010-June 2011, 81 children were hospitalized. Demographic data, costs and parental care, response to treatment, adverse events and complications were registered.

RESULTS: There was no difference in the effectiveness of both treatments (100% in OPAT and 98.6% in inpatient cohort, p: 0.41). Adherence to OPAT was 100%. Prevalence of adverse events was higher in inpatient cohort (76.3% versus 16.2%, p < 0.01). The average direct cost was four times higher in inpatients, mainly due to bed-day cost. Indirect cost was similar in both groups. There were more days of absence from work and care centers in inpatients (p: 0.017, p: 0.045 respectively).

CONCLUSION: OPAT for febrile UTI was equally effective, safer and significantly less expensive than inpatient care. OPAT represents a recommended intervention for pediatric services of Chilean public hospitals.

Written by:
Peña A, Zambrano A, Alvarado M, Cerda J, Vergara R.   Are you the author?
Departamento de Pediatría, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

Reference: Rev Chilena Infectol. 2013 Aug;30(4):426-34.
doi: 10.4067/S0716-10182013000400012

PubMed Abstract
PMID: 24248113

Article in Spanish.

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