Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Brazilian Journal of Infectious Diseases |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000300009 |
Resumo: | Abstract Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT) is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources. The Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da USP (IOT) started, in July 2013, a partnership with municipal health authorities in Sao Paulo, Brazil, in order to initiate an OPAT program in which patients discharged from that hospital would be able to continue antimicrobial therapy at primary care facilities. When necessary, patients could also receive their therapy at the day-hospital located at IOT. Primary care nursing and physician staff were trained about antimicrobial infusion and peripherally inserted central catheter manipulation. An OPAT specific antimicrobial protocol was designed and a special reference and counter-reference organized. As a result, 450 primary healthcare professionals were trained. In the first year of this program, 116 patients were discharged for OPAT. Chronic and acute osteomyelitis were most frequent diagnosis. Teicoplanin, ertapenem and tigecycline were the most used drugs. Duration of treatment varied from 10 to 180 days (average 101, median 42). Total sum of days in OPAT regimen was 11,698. Only 3 patients presented adverse effects. Partnership between services of different levels of complexity allowed implantation of a safe and effective public healthcare OPAT program for treatment of orthopedic infections. This program can serve as a model for developing similar strategies in other regions of Brazil and Latin America. |
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Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in BrazilHome infusion therapyAmbulatory care facilitiesPublic healthcare practiceOsteomyelitisAbstract Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT) is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources. The Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da USP (IOT) started, in July 2013, a partnership with municipal health authorities in Sao Paulo, Brazil, in order to initiate an OPAT program in which patients discharged from that hospital would be able to continue antimicrobial therapy at primary care facilities. When necessary, patients could also receive their therapy at the day-hospital located at IOT. Primary care nursing and physician staff were trained about antimicrobial infusion and peripherally inserted central catheter manipulation. An OPAT specific antimicrobial protocol was designed and a special reference and counter-reference organized. As a result, 450 primary healthcare professionals were trained. In the first year of this program, 116 patients were discharged for OPAT. Chronic and acute osteomyelitis were most frequent diagnosis. Teicoplanin, ertapenem and tigecycline were the most used drugs. Duration of treatment varied from 10 to 180 days (average 101, median 42). Total sum of days in OPAT regimen was 11,698. Only 3 patients presented adverse effects. Partnership between services of different levels of complexity allowed implantation of a safe and effective public healthcare OPAT program for treatment of orthopedic infections. This program can serve as a model for developing similar strategies in other regions of Brazil and Latin America.Brazilian Society of Infectious Diseases2016-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000300009Brazilian Journal of Infectious Diseases v.20 n.3 2016reponame:Brazilian Journal of Infectious Diseasesinstname:Brazilian Society of Infectious Diseases (BSID)instacron:BSID10.1016/j.bjid.2016.03.005info:eu-repo/semantics/openAccessOliveira,Priscila RosalbaFelix,Cassia da SilvaCarvalho,Vladimir Cordeiro deGiovani,Arlete MazziniReis,Rosangela Suarti dosBeraldo,MarisaAlbuquerque,Edmir PeraltaFerreira Junior,Walter CintraSilva,Jorge dos SantosLima,Ana Lucia Leieng2016-11-01T00:00:00Zoai:scielo:S1413-86702016000300009Revistahttps://www.bjid.org.br/https://old.scielo.br/oai/scielo-oai.phpbjid@bjid.org.br||lgoldani@ufrgs.br1678-43911413-8670opendoar:2016-11-01T00:00Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID)false |
dc.title.none.fl_str_mv |
Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil |
title |
Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil |
spellingShingle |
Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil Oliveira,Priscila Rosalba Home infusion therapy Ambulatory care facilities Public healthcare practice Osteomyelitis |
title_short |
Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil |
title_full |
Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil |
title_fullStr |
Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil |
title_full_unstemmed |
Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil |
title_sort |
Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil |
author |
Oliveira,Priscila Rosalba |
author_facet |
Oliveira,Priscila Rosalba Felix,Cassia da Silva Carvalho,Vladimir Cordeiro de Giovani,Arlete Mazzini Reis,Rosangela Suarti dos Beraldo,Marisa Albuquerque,Edmir Peralta Ferreira Junior,Walter Cintra Silva,Jorge dos Santos Lima,Ana Lucia Lei |
author_role |
author |
author2 |
Felix,Cassia da Silva Carvalho,Vladimir Cordeiro de Giovani,Arlete Mazzini Reis,Rosangela Suarti dos Beraldo,Marisa Albuquerque,Edmir Peralta Ferreira Junior,Walter Cintra Silva,Jorge dos Santos Lima,Ana Lucia Lei |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Oliveira,Priscila Rosalba Felix,Cassia da Silva Carvalho,Vladimir Cordeiro de Giovani,Arlete Mazzini Reis,Rosangela Suarti dos Beraldo,Marisa Albuquerque,Edmir Peralta Ferreira Junior,Walter Cintra Silva,Jorge dos Santos Lima,Ana Lucia Lei |
dc.subject.por.fl_str_mv |
Home infusion therapy Ambulatory care facilities Public healthcare practice Osteomyelitis |
topic |
Home infusion therapy Ambulatory care facilities Public healthcare practice Osteomyelitis |
description |
Abstract Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT) is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources. The Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da USP (IOT) started, in July 2013, a partnership with municipal health authorities in Sao Paulo, Brazil, in order to initiate an OPAT program in which patients discharged from that hospital would be able to continue antimicrobial therapy at primary care facilities. When necessary, patients could also receive their therapy at the day-hospital located at IOT. Primary care nursing and physician staff were trained about antimicrobial infusion and peripherally inserted central catheter manipulation. An OPAT specific antimicrobial protocol was designed and a special reference and counter-reference organized. As a result, 450 primary healthcare professionals were trained. In the first year of this program, 116 patients were discharged for OPAT. Chronic and acute osteomyelitis were most frequent diagnosis. Teicoplanin, ertapenem and tigecycline were the most used drugs. Duration of treatment varied from 10 to 180 days (average 101, median 42). Total sum of days in OPAT regimen was 11,698. Only 3 patients presented adverse effects. Partnership between services of different levels of complexity allowed implantation of a safe and effective public healthcare OPAT program for treatment of orthopedic infections. This program can serve as a model for developing similar strategies in other regions of Brazil and Latin America. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000300009 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000300009 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1016/j.bjid.2016.03.005 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Brazilian Society of Infectious Diseases |
publisher.none.fl_str_mv |
Brazilian Society of Infectious Diseases |
dc.source.none.fl_str_mv |
Brazilian Journal of Infectious Diseases v.20 n.3 2016 reponame:Brazilian Journal of Infectious Diseases instname:Brazilian Society of Infectious Diseases (BSID) instacron:BSID |
instname_str |
Brazilian Society of Infectious Diseases (BSID) |
instacron_str |
BSID |
institution |
BSID |
reponame_str |
Brazilian Journal of Infectious Diseases |
collection |
Brazilian Journal of Infectious Diseases |
repository.name.fl_str_mv |
Brazilian Journal of Infectious Diseases - Brazilian Society of Infectious Diseases (BSID) |
repository.mail.fl_str_mv |
bjid@bjid.org.br||lgoldani@ufrgs.br |
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1754209243736571904 |