Outcomes Of Central Nervous System Infections Treated By An Outpatient Parenteral Antimicrobial Therapy Program In A Public Teaching Hospital

BackgroundOutpatient parenteral antimicrobial therapy (OPAT) has been safely used to treat a variety of infections. However, limited data are available on the safety and efficacy of OPAT for central nervous system (CNS) infections. MethodsThis was a retrospective, single-center study evaluating the safety and efficacy of OPAT in patients with CNS infections between July 1, 2009, and May 31, 2016. Demographic, medical, infection-specific, and drug-specific data were collected for each patient. Patients were categorized as clinical cure, probable cure, or treatment failure based on resolution or recurrence of infection for up to 1 year after OPAT completion. Safety of OPAT was evaluated through adverse drug event (ADE) and line complication (LC) monitoring. Readmission rates from OPAT-related ADE and LC were also recorded. ResultsForty-seven patients with CNS infections (mean age, 45.3 years; 70.2% male) received OPAT for a median duration of 12 days (range, 2-144 days); 1 patient was excluded from efficacy analysis because of hospice transition. Thirty-seven patients (80.4%) achieved clinical cure, 7 patients (15.2%) had probable cure, and 2 patients (4.3%) experienced treatment failure. Three patients (6.4%) experienced ADE and 4 patients (8.5%) experienced LC during OPAT. Five patients (10.6%) required rehospitalization because of worsening infection (n = 1), LC (n = 2), cerebrospinal fluid leak repair (n = 1), and insurance issues (n = 1). Six patients (12.8%) required a therapy change because of ADE or LC. ConclusionsTreating CNS infections with OPAT seems to be safe and effective based on the low failure and complication rates observed in this study.