751Outpatient Parenteral Antimicrobial Therapy (OPAT) Outcomes at a Tertiary Care Hospital.

updated) Background: The practice of OPAT became widespread with demonstration of its safety in selected patients. However, with concerted efforts to reduce hospital lengths of stay, there is currently no selection for OPAT. Virtually every patient is a potential candidate for OPAT. Data on OPAT outcomes with unselected patients are very limited. The purpose of this study was to evaluate clinical outcomes and complications in an unselected cohort of patients treated with OPAT at a tertiary care hospital. Methods: All OPAT courses at Cleveland Clinic over 18 months were identified from the institution’s OPAT registry. For each treatment course, outcomes at the end of the treatment course were abstracted through review of the electronic medical record. ED visits and hospital readmissions while on OPAT were enumerated. A successful clinical outcome was defined as cure, successful suppression or improvement at the end of therapy. Results: From January 1, 2013 to July 1, 2014, 4590 OPAT courses were administered at Cleveland Clinic. The total number of OPAT days was 102879. The treatment sites were home (61%), facilities (34%), dialysis centers (3%) and infusion centers (<1%). The vascular access device was a PICC in 3381 instances (74%). The treatment outcome was undefined in 898 (20%) courses because of early termination of treatment. The outcomes in the remaining 3692 OPAT courses were as follows: clinical cure 2206 (60%), improved 463 (13%), successfully suppressed 333 (9%), failed therapy 26 (<1%) and unknown 664 (18%). 861 (19%) of OPAT courses were interrupted by rehospitalization, which occurred a mean of 17 days after discharge from hospital. Conclusions: Among all patients discharged from hospital on OPAT from a tertiary care hospital, over 80% of patients who complete the treatment course have a successful clinical outcome. Hospital readmissions while on OPAT occur frequently. Methods OPAT courses at Cleveland Clinic were identified from the institution’s OPAT registry which includes all patients discharged from hospital on parenteral antimicrobials. All OPAT courses for patients discharged from hospital from January 1, 2013 to July 1, 2014 were selected. Results were stratified by OPAT site into: home, facilities (skilled nursing facilities and long-term acute care centers), dialysis centers, and infusion centers. For each treatment course, outcomes at the end of the treatment course were abstracted through review of the electronic medical record. ED visits and hospital readmissions while on OPAT were enumerated. A successful clinical outcome was defined as cure, successful suppression or improvement at the end of therapy. Introduction The practice of OPAT became widespread with demonstration of its safety in selected patients. However, with concerted efforts to reduce hospital lengths of stay, there is currently no selection for OPAT. Virtually every patient is a potential candidate for OPAT. Data on OPAT outcomes with unselected patients are very limited. The purpose of this study was to evaluate clinical outcomes and complications in an unselected cohort of patients treated with OPAT at a tertiary care hospital.