Outpatient ertapenem therapy in an ESBL-high-prevalence area: an efficacy, safety, and cost study

Figures & data

Table 1 Baseline characteristics of the 99 patients with OET

Characteristics	N (% or SD)
Female	61 (62)
Mean age (years)	48±17
Diabetes mellitus	39 (39)
Arterial systemic hypertension	19 (19)
Liver disease	5 (5)
Human immunodeficiency virus infection	2 (2)
Immunosuppressive therapy	3 (3)
Glomerular filtration rate <60 mL/min	3 (3)
Obesity	17 (17)
Surgery in the preceding 3 months	25 (25)
Hospitalization in the preceding 3 months	45 (45)

Abbreviation: OET, outpatient ertapenem therapy.

Table 2 Clinical outcomes of patients with OET

Type of infection	N	In-hospital lengthof-stay plus OET days (mean ± SD)	OET days (mean ± SD)	Cure (%)	Readmission after OET	Relapse or recurrence	Phlebitis
UTI	55	14±9	7±6	96	2	2	1
Abdominal abscess	21	15±10	8±6	100	0	0	0
SSTI	9	13±9	6±5	89	0	1	0
JBI	7	42±10	25±6	100	1	0	1
GTI	4	13±8	10±6	100	0	0	0
CR-BSI	3	14±8	10±5	100	0	0	0
Total	99	15±9	9±6	97	3	3	2

Abbreviations: CR-BSI, catheter-related bloodstream infection; OET, outpatient ertapenem therapy; GTI, genital tract infection; JBI, joint and bone infection; SSTI, skin and soft tissue infection; UTI, urinary tract infection.

Table 3 Microbiological data

Samples	N	Microorganism	n (%)
Urine culturea	49	ESBL-producing E. coli	29 (59)
		None	20 (41)
Blood cultureb	55	ESBL-producing E. coli	19 (34)
		ESBL-producing Salmonella	1 (2)
		None	35 (64)
Abdominal abscess	18	ESBL-producing E. coli	14 (78)
		Citrobacter freundii	1 (5)
		None	3 (17)

a Notes: Patients with urinary tract infection (pyelonephritis, renal abscess and cystitis),

b total population.

Abbreviations: ESBL, extended-spectrum-β-lactamase-eliminar producing Enterobacteriaceae; SSTI, skin and soft tissue infection; UTI, urinary tract infection.

Table 4 Comparison of mean cost of treatment in patients with uncomplicated pyelonephritis

Socioeconomic status	OET	IET	P
1	$273.1 (n=7)	$1,032.05 (n=9)	0.002
2	$490.7 (n=13)	$1,300 (n=10)

Notes: Results based on mean cost of hospitalization at SS 1 and 2.

Abbreviations: IET, inpatient ertapenem therapy; OET, outpatient ertapenem therapy.

Figure 1 Antimicrobial stewardship at Dr Manuel Gea Gonzalez Hospital.

Notes: After the categorization of an infectious syndrome by the patient’s consultant physician (emergency, internal medicine, surgery, orthopedics, gynecology, and obstetrics), the infectious disease team prescribe antibiotic according to the diagnosis and local resistance. When any service requires an antimicrobial, the pharmacovigilance unit works together with ID and microbiology departments to assess, discuss, and decide if the patient requires the antimicrobial prescribed. After the assessment, the route of the antimicrobial treatment follows this flowchart. At the end, if the patient still needs antimicrobial treatment then they will be transferred to the OPAT.

Abbreviations: ID, Infectious Diseases; OPAT, outpatient antimicrobial treatment.