Publication:
Outpatient Parenteral Antibiotic Treatment vs Hospitalization for Infective Endocarditis: Validation of the OPAT-GAMES Criteria.

dc.contributor.authorPericas, Juan M
dc.contributor.authorLlopis, Jaume
dc.contributor.authorMuñoz, Patricia
dc.contributor.authorGonzalez-Ramallo, Victor
dc.contributor.authorGarcia-Leoni, M Eugenia
dc.contributor.authorde-Alarcon, Aristides
dc.contributor.authorLuque, Rafael
dc.contributor.authorFariñas, M Carmen
dc.contributor.authorGoenaga, Miguel A
dc.contributor.authorHernandez-Meneses, Marta
dc.contributor.authorNicolas, David
dc.contributor.authorRamos-Martinez, Antonio
dc.contributor.authorRodriguez-Esteban, M Angeles
dc.contributor.authorVilloslada-Gelabert, Aroa
dc.contributor.authorMiro, Jose M
dc.contributor.funderMinisterio de Sanidad y Consumo of Spain
dc.contributor.groupGAMES Investigators
dc.date.accessioned2023-05-03T13:27:49Z
dc.date.available2023-05-03T13:27:49Z
dc.date.issued2022-08-30
dc.description.abstractBackgroundOutpatient parenteral antibiotic treatment (OPAT) programs are increasingly used to manage infective endocarditis (IE), but current criteria for indicating OPAT are markedly conservative. We aimed to investigate whether more liberal criteria for indicating OPAT in IE can be safely used.MethodsThis was a prospective multicenter nationwide cohort study (2008–2018). Rates of readmission, recurrences , and 1-year mortality were compared between hospital -based antibiotic treatment (HBAT) and OPAT. Risk factors for readmission and mortality in OPAT patients were investigated by logistic regression . Patients did not fulfill OPAT-GAMES (Grupos de Apoyo al Manejo de la Endocarditis en ESpaña) criteria if they had any of the following: cirrhosis , severe central nervous system emboli, undrained abscesses , severe conditions requiring cardiac surgery in nonoperable patients , severe postsurgical complications, highly difficult-to-treat microorganisms, or intravenous drug use.ResultsA total of 2279 HBAT patients and 1268 OPAT patients were included. Among OPAT patients , 307 (24.2%) did not fulfill OPAT-GAMES criteria. Overall, OPAT patients presented higher rates of readmission than HBAT patients (18.2% vs 14.4%; P = .004), but no significant differences were found in the propensity analysis. Patients not fulfilling OPAT-GAMES criteria presented significantly higher rates of readmission than HBAT and OPAT-GAMES (23.8%, 14.4%, 16.4%; P < .001), whereas no significant differences were found in mortality (5.9%, 8%, 7.4%; P = .103) or recurrences (3.9%, 3.1%, 2.5%; P = .546). Not fulfilling OPAT-GAMES criteria was associated with higher risk of readmission ( odds ratio [OR], 1.43; 95% CI, 1.03–1.97; P = .03), whereas cardiac surgery was associated with lower risk (OR, 0.72; 95% CI, 0.53–0.98; P = .03). ConclusionsOPAT-GAMES criteria allow identification of IE patients at higher risk of long-term complications to whom OPAT cannot be safely administered.
dc.description.versionSi
dc.identifier.citationPericàs JM, Llopis J, Muñoz P, González-Ramallo V, García-Leoni ME, de Alarcón A, et al, Outpatient Parenteral Antibiotic Treatment vs Hospitalization for Infective Endocarditis: Validation of the OPAT-GAMES Criteria. Open Forum Infect Dis. 2022 Aug 30;9(9):ofac442.
dc.identifier.doi10.1093/ofid/ofac442
dc.identifier.issn2328-8957
dc.identifier.pmcPMC9512706
dc.identifier.pmid36172059
dc.identifier.pubmedURLhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9512706/pdf
dc.identifier.unpaywallURLhttps://academic.oup.com/ofid/article-pdf/9/9/ofac442/46041811/ofac442.pdf
dc.identifier.urihttp://hdl.handle.net/10668/19826
dc.issue.number9
dc.journal.titleOpen forum infectious diseases
dc.journal.titleabbreviationOpen Forum Infect Dis
dc.language.isoen
dc.organizationInstituto de Biomedicina de Sevilla-IBIS
dc.page.number8
dc.provenanceRealizada la curación de contenido 24/06/2025.
dc.publisherOxford University Press
dc.pubmedtypeJournal Article
dc.relation.projectIDFIS PI19/0898
dc.relation.publisherversionhttps://academic.oup.com/ofid/article-lookup/doi/10.1093/ofid/ofac442
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.accessRightsopen access
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectinfective endocarditis
dc.subjectmortality
dc.subjectoutpatient parenteral antibiotic treatment
dc.subjectreadmission
dc.subjectrecurrences
dc.subject.decsMortalidad
dc.subject.decsEndocarditis
dc.subject.decsAntibacterianos
dc.subject.decsSistema nervioso central
dc.subject.decsFibrosis
dc.subject.decsCirugía torácica
dc.subject.decsAbsceso
dc.subject.meshAnti-Bacterial Agents
dc.subject.meshAbscess
dc.subject.meshEndocarditis
dc.subject.meshLiver Cirrhosis
dc.subject.meshCardiac Surgical Procedures
dc.subject.meshCentral Nervous System
dc.titleOutpatient Parenteral Antibiotic Treatment vs Hospitalization for Infective Endocarditis: Validation of the OPAT-GAMES Criteria.
dc.typeresearch article
dc.type.hasVersionVoR
dc.volume.number9
dspace.entity.typePublication

Files

Original bundle

Now showing 1 - 2 of 2
Loading...
Thumbnail Image
Name:
PMC9512706.pdf
Size:
456.67 KB
Format:
Adobe Portable Document Format
No Thumbnail Available
Name:
Pericas_OutpatientParenteral_MaterialSuplementario.zip
Size:
1.15 MB
Format: