%0 Journal Article 
%A Castillo Fernández, Nerea
%A Martínez Pérez-Crespo, Pedro María
%A Salamanca Rivera, Elena
%A Herrera Hidalgo, Laura
%A de Alarcón, Arístides
%A Navarro Amuedo, María Dolores
%A Marrodán Ciordia, Teresa
%A Pérez Rodríguez, María Teresa
%A Sevilla Blanco, Juan
%A Jóver Saenz, Alfredo
%A Fernández Suárez, Jonathan
%A Armiñanzas Castillo, Carlos
%A Reguera Iglesias, José María
%A Natera Kindelán, Clara
%A Boix Palop, Lucía
%A León Jiménez, Eva
%A Galán Sánchez, Fátima
%A del Arco Jiménez, Alfonso
%A Bahamonde Carrasco, Alberto
%A Vinuesa García, David
%A Smithson Amat, Alejandro
%A Cuquet Pedragosa, Jordi
%A Reche Molina, Isabel María
%A Pérez Camacho, Inés
%A Merino de Lucas, Esperanza
%A Gutiérrez Gutiérrez, Belén
%A Rodríguez Baño, Jesús
%A López Cortés, Luis Eduardo
%T Conventional Hospitalization versus Sequential Outpatient Parenteral Antibiotic Therapy for Staphylococcus aureus Bacteremia: Post-Hoc Analysis of a Multicenter Observational Cohort
%D 2023
%@ 2079-6382
%U http://hdl.handle.net/10498/31202
%X It is not known whether sequential outpatient parenteral antimicrobial (OPAT) is as safe and effective as conventional hospitalization in patients with S. aureus bacteremia (SAB). A post-hoc analysis of the comparative effectiveness of conventional hospitalization versus sequential OPAT was performed in two prospective Spanish cohorts of patients with S. aureus bacteremia. The PROBAC cohort is a national, multicenter, prospective observational cohort of patients diagnosed in 22 Spanish hospitals between October 2016 and March 2017. The DOMUS OPAT cohort is a prospective observational cohort including patients from two university hospitals in Seville, Spain from 2012 to 2021. Multivariate regression was performed, including a propensity score (PS) for receiving OPAT, stratified analysis according to PS quartiles, and matched pair analyses based on PS. Four hundred and thirteen patients were included in the analysis: 150 in sequential OPAT and 263 in the full hospitalization therapy group. In multivariate analysis, including PS and center effect as covariates, 60-day treatment failure was lower in the OPAT group than in the full hospitalization group (p < 0.001; OR 0.275, 95%CI 0.129–0.584). In the PS-based matched analyses, sequential treatment under OPAT was not associated with higher 60-day treatment failure (p = 0.253; adjusted OR 0.660; % CI 0.324–1.345). OPAT is a safe and effective alternative to conventional in-patient therapy for completion of treatment in well-selected patients with SAB, mainly those associated with a low-risk source and without end-stage kidney disease.
%K bacteremia
%K outpatient parenteral antimicrobial therapy
%K Staphylococcus aureus
%~ Universidad de Cádiz