Implementation and evaluation of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada
Abstract Objective: We describe the implementation, outcomes, and challenges of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada to provide a framework for those interested in establishing such a program. Setting: Outpatient ambulatory clinic led by infectious diseases p...
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Cambridge University Press
2025-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X25000191/type/journal_article |
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| author | Maggie Wong Davie Wong |
| author_facet | Maggie Wong Davie Wong |
| author_sort | Maggie Wong |
| collection | DOAJ |
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Abstract
Objective:
We describe the implementation, outcomes, and challenges of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada to provide a framework for those interested in establishing such a program.
Setting:
Outpatient ambulatory clinic led by infectious diseases physicians, serving patients from a tertiary hospital and a small community hospital.
Design:
Retrospective observational study that evaluated the efficacy, safety, and cost savings of patients enrolled in the program from August 2023 to June 2024.
Results:
One hundred three patients were included, of which 84.4% achieved successful clinical outcomes. Mean age of the patients was 62 years and 30% had diabetes. The top three sources of infections were bone and joint, intra-abdominal, and skin-and-soft tissue. Mean duration of COpAT was 37 days. Seventy-five percent of patients required only a single agent, and amoxicillin/clavulanic acid was most commonly used. Twenty-two patients developed an adverse reaction, of which three required a change in therapy and one resolved with antibiotic dose reduction. No C. difficile infections or mortality were reported 30-days post COpAT discharge. Twelve patients were re-admitted to the hospital; 50% of the cases were unrelated to infections. Compared to outpatient intravenous therapy, the total cost savings from COpAT were estimated to be $255,000 Canadian dollars (CAD), which translated to an average cost savings of $2500 CAD per patient per year.
Conclusion:
We demonstrated favorable clinical and safety outcomes with our COpAT program and substantial cost savings using existing infrastructure. COpAT allows efficient use of healthcare resources including decongestion of hospitals.
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| format | Article |
| id | doaj-art-0752db8246c44cc283c6f9ddbaeb6c2d |
| institution | Kabale University |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-0752db8246c44cc283c6f9ddbaeb6c2d2025-02-12T08:13:48ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2025.19Implementation and evaluation of a complex outpatient oral antimicrobial therapy program (COpAT) in CanadaMaggie Wong0Davie Wong1https://orcid.org/0009-0003-9407-4261Fraser Health Authority, University of British Columbia, Canada Department of Pharmacy, Royal Columbian Hospital, New Westminster, BC, CanadaFraser Health Authority, University of British Columbia, Canada Division of Infectious Diseases, Department of Medicine, Royal Columbian Hospital, New Westminster, BC, Canada Abstract Objective: We describe the implementation, outcomes, and challenges of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada to provide a framework for those interested in establishing such a program. Setting: Outpatient ambulatory clinic led by infectious diseases physicians, serving patients from a tertiary hospital and a small community hospital. Design: Retrospective observational study that evaluated the efficacy, safety, and cost savings of patients enrolled in the program from August 2023 to June 2024. Results: One hundred three patients were included, of which 84.4% achieved successful clinical outcomes. Mean age of the patients was 62 years and 30% had diabetes. The top three sources of infections were bone and joint, intra-abdominal, and skin-and-soft tissue. Mean duration of COpAT was 37 days. Seventy-five percent of patients required only a single agent, and amoxicillin/clavulanic acid was most commonly used. Twenty-two patients developed an adverse reaction, of which three required a change in therapy and one resolved with antibiotic dose reduction. No C. difficile infections or mortality were reported 30-days post COpAT discharge. Twelve patients were re-admitted to the hospital; 50% of the cases were unrelated to infections. Compared to outpatient intravenous therapy, the total cost savings from COpAT were estimated to be $255,000 Canadian dollars (CAD), which translated to an average cost savings of $2500 CAD per patient per year. Conclusion: We demonstrated favorable clinical and safety outcomes with our COpAT program and substantial cost savings using existing infrastructure. COpAT allows efficient use of healthcare resources including decongestion of hospitals. https://www.cambridge.org/core/product/identifier/S2732494X25000191/type/journal_article |
| spellingShingle | Maggie Wong Davie Wong Implementation and evaluation of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Implementation and evaluation of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada |
| title_full | Implementation and evaluation of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada |
| title_fullStr | Implementation and evaluation of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada |
| title_full_unstemmed | Implementation and evaluation of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada |
| title_short | Implementation and evaluation of a complex outpatient oral antimicrobial therapy program (COpAT) in Canada |
| title_sort | implementation and evaluation of a complex outpatient oral antimicrobial therapy program copat in canada |
| url | https://www.cambridge.org/core/product/identifier/S2732494X25000191/type/journal_article |
| work_keys_str_mv | AT maggiewong implementationandevaluationofacomplexoutpatientoralantimicrobialtherapyprogramcopatincanada AT daviewong implementationandevaluationofacomplexoutpatientoralantimicrobialtherapyprogramcopatincanada |