751Outpatient Parenteral Antimicrobial Therapy (OPAT) Outcomes at a Tertiary Care Hospital

Background. The practice of OPAT became widespread with demonstration of its safety in selected patients. However, with concerted efforts to reduce hospital lengths of stay, there is currently no selection for OPAT. Virtually every patient is a potential candidate for OPAT. Data on OPAT outcomes with unselected patients are very limited. The purpose of this study was to evaluate clinical outcomes and complications in an unselected cohort of patients treated with OPAT at a tertiary care hospital. Methods. All OPAT courses at Cleveland Clinic over one calendar year were identified from the institution’s OPAT registry. For each treatment course, outcomes at the end of the treatment course were abstracted through review of the electronic medical record. ED visits and hospital readmissions while on OPAT were enumerated. A successful clinical outcome was defined as cure, successful suppression or improvement at the end of therapy. Results. From January 1, 2013 to January 1, 2014, 3162 OPAT courses were administered at Cleveland Clinic. The total number of OPAT days was 69545. The treatment sites were home (62%), facilities (34%), dialysis centers (3%) and infusion centers (<1%). The vascular access device was a PICC in 2340 instances (74%). The treatment outcome was undefined in 655 (21%) courses because of early termination of treatment. The outcomes in the remaining 2507 OPAT courses were as follows: clinical cure 1450 (58%), improved 326 (13%), successfully suppressed 231 (9%), failed therapy 24 (1%) and unknown 476 (19%). About 15% of OPAT courses were complicated by at least one ED visit and 21% were interrupted by rehospitalization, the latter occurring a mean of 16 days after discharge from hospital. Conclusion. Among all patients discharged from hospital on OPAT from a tertiary care hospital, at least 80% of patients who complete the treatment course have a successful clinical outcome. ED visits and hospital readmission are common. Disclosures. N. Shrestha, Forest: Speaker’s Bureau, Speaker honorarium; Merck: Speaker’s Bureau, Speaker honorarium; The Medicines Company: Scientific Advisor, Consulting fee S. J. Rehm, Pfizer: Scientific Advisor, Consulting fee; Merck: Scientific Advisor, Consulting fee