740Hospital Avoidance Utilizing an ID Supervised OPAT Program

Background. Evaluate the effectiveness of an infectious disease physician managed outpatient antibiotic therapy (OPAT) program. Methods. A retrospective chart review of 3754 patients from August 2011 through July 2013 who received intravenous OPAT through our program. Patients were either initiated in the hospital (HI) or in the office (OI). Results. 3754 patients were initiated or continued on IV antibiotics for 3 days or longer in the outpatient setting after evaluation by an infectious disease (ID) specialist. Evaluated therapy was delivered exclusively in the outpatient setting. The age of patients ranged from 2-99 years old (average 60). Predominant diagnoses were (Bone/ Joint) B/J: 30.1%, (Skin/Soft Tissue) S/ST: 25%, Abscess: 15.2%, UTI: 10.1%. Most common antibiotics were Ertapenem: 26.7%, Daptomycin: 25%, Ceftriaxone: 24.7 %, Vancomycin: 24.5%. 524 patients required at least 2 antibiotics during therapy. Duration of therapy for specific diagnoses: B/J: 34.7 days, S/ST: 14.22 days, UTI: 11.8 days, Abscess: 22.9 days. Outcomes were defined as success, modified success and failure. Success was defined as cure without relapse or admission due to primary infectious diagnosis. Modified success was defined as success with line complications or adverse drug reactions but without hospital admission. Failure was defined as relapse within 30 days of therapy completion or hospitalization due to progression of primary infection or treatment complication. Failures were seen in 200 patients (5.33%), with 91 relapses (2.42%), 66 primary infection progressions (1.76%), and 43 admissions due to therapeutic complications (1.15%). Relapses were more commonly seen in OI and primary infection progressions in HI patients. Overall cure rates were 94.67%. Total number of patients requiring hospitalization after admission to our program was 109 (2.9%). Conclusion. An ID physician supervised OPAT program is safe, efficient, and cost effective. With the continued push for alternatives to inpatient care, it becomes increasingly important for ID physicians to play a role in outpatient care to optimize outcomes, reduce hospital utilization, minimize complications, and maximize cost containment. This program will meet the needs of patients, payers, and healthcare facilities as healthcare reform continues. Disclosures. R. Petrak, HHI Infusion: Board Member, Consulting fee R. Fliegelman, HHI Infusion: Shareholder, Dividends