Implementing Oral Antibiotics for Bone and Joint Infections: Lessons Learned and Opportunities for Improvement.

IF 3.8 4区 医学 Q2 IMMUNOLOGY
Open Forum Infectious Diseases Pub Date : 2024-11-16 eCollection Date: 2024-12-01 DOI:10.1093/ofid/ofae683
Marten R Hawkins, Elizabeth Thottacherry, Prerak Juthani, Jenny Aronson, Amy Chang, Derek F Amanatullah, Jessie Markovits, Sa Shen, Marisa Holubar, Jason R Andrews, Julie Parsonnet, Daisuke Furukawa
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引用次数: 0

Abstract

Background: Although intravenous antibiotics have historically been the standard of care for bone and joint infections, clinical trial data have highlighted the safety and efficacy of oral antibiotics. Despite this, intravenous antibiotics are still commonly used, and evaluations of institutional guidelines advancing oral antibiotic use are limited.

Methods: In April 2023, we implemented a new institutional guideline to preferentially treat patients with bone and joint infections with oral antibiotics. The postguideline cohort was compared with a historical preguideline cohort via retrospective chart review. The primary outcome was the proportion of patients discharged exclusively on oral antibiotics. Secondary outcomes included 90-day treatment failure, length of stay, and adverse effects.

Results: One hundred eighty-six patients (53 preguideline and 133 postguideline) were included in the analysis. Patients in the postguideline cohort were more likely to be discharged exclusively on oral antibiotics (25% vs 70%; P < .01), with no difference in 90-day treatment failure (8% vs 9%; P = .75). Patients in the postguideline cohort had a shorter length of stay than preguideline (median, 8 vs 7 days; P = .04) and trended toward fewer peripherally inserted central catheter-related adverse events (6% vs 1%; P = .07).

Conclusions: An institutional guideline was effective in increasing the proportion of patients with bone and joint infections discharged on oral antibiotics. We observed similar clinical outcomes after implementing the guidelines while reducing length of hospital stay.

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来源期刊
Open Forum Infectious Diseases
Open Forum Infectious Diseases Medicine-Neurology (clinical)
CiteScore
6.70
自引率
4.80%
发文量
630
审稿时长
9 weeks
期刊介绍: Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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