Outpatient parenteral antibiotic therapy with daptomycin: insights from a patient registry

• Published in: International journal of clinical practice (Esher) Vol. 62; no. 8; pp. 1183 - 1187
• Main Authors: Martone, W. J., Lindfield, K. C., Katz, D. E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.08.2008; Blackwell; Hindawi Limited
• Subjects: Aged; Ambulatory Care - standards; Ambulatory Care - statistics & numerical data; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - adverse effects; Antibacterial agents; Antibiotics; Antibiotics. Antiinfectious agents. Antiparasitic agents; Bacterial Infections - drug therapy; Biological and medical sciences; Clinical outcomes; Comparative studies; Daptomycin - administration & dosage; Daptomycin - adverse effects; Drug therapy; Epidemiologic Methods; Female; Home Infusion Therapy - statistics & numerical data; Hospitalization - statistics & numerical data; Humans; Infusions, Parenteral; Inpatient care; Male; Medical sciences; Middle Aged; Original Paper; Outpatient care facilities; Patient Satisfaction; Pharmacology. Drug treatments; Treatment Outcome; Human; Medicine; Antibiotic; Treatment; Peptides; Daptomycin; Ambulatory; Antibacterial agent; Lipopeptide; Parenteral administration
• ISSN: 1368-5031; 1742-1241
• DOI: 10.1111/j.1742-1241.2008.01824.x

Summary Aim:  To compare and contrast the characteristics and clinical outcomes of patients who have received daptomycin as outpatients and inpatients. Methods:  The Cubicin Outcomes Registry and Experience (CORE) is a retrospective chart review of patients who have received daptomycin in participating institutions. Patients treated in 2005 were included in this analysis. Demographic characteristics and clinical outcomes (success = cured + improved) were compared among patients who received outpatient parenteral antibiotic therapy (OPAT) and patients who had received inpatient parenteral antibiotic therapy (IPAT). Results:  Of 1172 patients reported by 52 CORE 2005 participating institutions/investigators, 949 (81.0%) patients were evaluable: 539 (56.8%) received OPAT (OPAT patients), and 410 (43.2%) received only IPAT (IPAT patients). Of the 539 OPAT patients, 273 (50.6%) also received some IPAT, usually preceding OPAT therapy. Successful outcomes [no. of successes/(no. of successes + no. of failures)] for OPAT patients vs. IPAT patients were 94.6% and 86.3% respectively (chi‐square test, p < 0.001). OPAT patients were younger, had fewer underlying diseases, were clinically stable, and had fewer adverse events than IPAT patients. Conclusions:  Outpatient parenteral antibiotic therapy use was common (539/949 or 56.8%) among patients in CORE 2005. Clinical outcomes among OPAT patients appeared at least as good as or better than IPAT patients. Better outcomes among OPAT patients were most likely because of patient selection for OPAT. Additional studies should focus on clinical characteristics of patients who would be ideal candidates for daptomycin OPAT.