756Emergency Department Visits During Outpatient Parenteral Antimicrobial Therapy (OPAT) Administered at Home

Background. Although administration of OPAT at home is now common practice, there is a paucity of data on the frequency of emergency department (ED) visits during such treatment. The purpose of this study was to describe ED visits while on OPAT at home. Methods. All OPAT courses carried out at home for patients at Cleveland Clinic over one calendar year were identified from the institution’s OPAT registry. For each treatment course ED visits that occurred while on OPAT were sought in the electronic medical record. Results. From January 1, 2013 to January 1, 2014, 1950 OPAT courses were carried out at home for 1464 patients, for a total of 43908 OPAT days. Mean patient age was 55 years. The vascular access device was a PICC in 1514 instances (78%). Of 257 ED visits, 117 (39%) were for OPAT-related complications (2.66 visits per 1,000 OPAT days). 98 (5%) OPAT courses had at least one ED visit for an OPAT-related problem, with a median time to first visit of 9 days after hospital discharge. Of the 117 OPAT-related ED visits, 17 (15%) were for antimicrobial adverse events (0.39 per 1,000 OPAT days) and 100 (85%) for vascular access complications (2.28 per 1,000 OPAT days). Five (30%) of 17 visits for antimicrobial adverse events and 20 (20%) of 100 ED visits for vascular access complications resulted in hospitalization. Conclusion. About one in 20 patients receiving OPAT at home has at least one ED visit for an OPAT-related complication during the course of treatment. The majority of these ED visits do not result in hospitalization. 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