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

Abstract Introduction A main goal of outpatient parenteral antibiotic therapy (OPAT) is to streamline patient care and minimize time spent in the inpatient hospital setting. The identification of characteristics of patients who return to the hospital after being discharged on OPAT may identify modif...

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Main Authors: Melanie Yousif, Matthew Geriak, Logan Vasina, George Sakoulas
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-07-01
Series:Infectious Diseases and Therapy
Subjects:
Online Access:https://doi.org/10.1007/s40121-025-01182-7
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author Melanie Yousif
Matthew Geriak
Logan Vasina
George Sakoulas
author_facet Melanie Yousif
Matthew Geriak
Logan Vasina
George Sakoulas
author_sort Melanie Yousif
collection DOAJ
description Abstract Introduction A main goal of outpatient parenteral antibiotic therapy (OPAT) is to streamline patient care and minimize time spent in the inpatient hospital setting. The identification of characteristics of patients who return to the hospital after being discharged on OPAT may identify modifiable steps that can be taken to reduce risk of hospital readmission as a practice improvement strategy. Methods We performed a retrospective analysis of adult patients prescribed OPAT for ≥ 14 days prescribed by infectious disease consultation for non-urinary tract infections (non-UTI). We compared characteristics including demographics, sites of infection, microbiology, and antimicrobial therapy prescribed. Results Of 233 adult OPAT patients with non-UTI infections receiving ID consultation, 61 (26%) were readmitted to the hospital (60 days), of which 37 (60%) were due to treatment failure. Ceftriaxone once daily was the most prescribed antimicrobial therapy. Microbiology and infection sites were similar between the two groups. Obesity (body mass index, BMI > 30 kg/m2) was more frequent among readmitted patients versus those not readmitted (odds ratio 3.6, 95% confidence interval 1.9–6.5, p < 0.0001). Polymicrobial infections were significantly more frequent among the readmitted group compared with the non-readmitted group (odds ratio 3.2, 95% confidence interval 1.7–6.0, p = 0.0004). Conclusions Patients with obesity may not be receiving sufficient antimicrobial exposure with standard antibiotic dosing regimens, particularly with ceftriaxone. Antibiotic dosing in patients with obesity requires further study and optimization, particularly with cephalosporins.
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spelling doaj-art-bf8cf43cf41e428eaeef50072b518ced2025-08-20T03:46:11ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822025-07-011481989199510.1007/s40121-025-01182-7Risk Factors for Hospital Readmission Following Outpatient Parenteral Antimicrobial Therapy (OPAT)Melanie Yousif0Matthew Geriak1Logan Vasina2George Sakoulas3Sharp Memorial Hospital PharmacySharp Healthcare Center for ResearchSharp Memorial Hospital PharmacySharp Rees Stealy Medical GroupAbstract Introduction A main goal of outpatient parenteral antibiotic therapy (OPAT) is to streamline patient care and minimize time spent in the inpatient hospital setting. The identification of characteristics of patients who return to the hospital after being discharged on OPAT may identify modifiable steps that can be taken to reduce risk of hospital readmission as a practice improvement strategy. Methods We performed a retrospective analysis of adult patients prescribed OPAT for ≥ 14 days prescribed by infectious disease consultation for non-urinary tract infections (non-UTI). We compared characteristics including demographics, sites of infection, microbiology, and antimicrobial therapy prescribed. Results Of 233 adult OPAT patients with non-UTI infections receiving ID consultation, 61 (26%) were readmitted to the hospital (60 days), of which 37 (60%) were due to treatment failure. Ceftriaxone once daily was the most prescribed antimicrobial therapy. Microbiology and infection sites were similar between the two groups. Obesity (body mass index, BMI > 30 kg/m2) was more frequent among readmitted patients versus those not readmitted (odds ratio 3.6, 95% confidence interval 1.9–6.5, p < 0.0001). Polymicrobial infections were significantly more frequent among the readmitted group compared with the non-readmitted group (odds ratio 3.2, 95% confidence interval 1.7–6.0, p = 0.0004). Conclusions Patients with obesity may not be receiving sufficient antimicrobial exposure with standard antibiotic dosing regimens, particularly with ceftriaxone. Antibiotic dosing in patients with obesity requires further study and optimization, particularly with cephalosporins.https://doi.org/10.1007/s40121-025-01182-7OPATReadmissionPolymicrobial infectionObesityAntibiotic dosing
spellingShingle Melanie Yousif
Matthew Geriak
Logan Vasina
George Sakoulas
Risk Factors for Hospital Readmission Following Outpatient Parenteral Antimicrobial Therapy (OPAT)
Infectious Diseases and Therapy
OPAT
Readmission
Polymicrobial infection
Obesity
Antibiotic dosing
title Risk Factors for Hospital Readmission Following Outpatient Parenteral Antimicrobial Therapy (OPAT)
title_full Risk Factors for Hospital Readmission Following Outpatient Parenteral Antimicrobial Therapy (OPAT)
title_fullStr Risk Factors for Hospital Readmission Following Outpatient Parenteral Antimicrobial Therapy (OPAT)
title_full_unstemmed Risk Factors for Hospital Readmission Following Outpatient Parenteral Antimicrobial Therapy (OPAT)
title_short Risk Factors for Hospital Readmission Following Outpatient Parenteral Antimicrobial Therapy (OPAT)
title_sort risk factors for hospital readmission following outpatient parenteral antimicrobial therapy opat
topic OPAT
Readmission
Polymicrobial infection
Obesity
Antibiotic dosing
url https://doi.org/10.1007/s40121-025-01182-7
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