Outpatient parenteral antimicrobial therapy with ceftriaxone for acute tonsillopharyngitis: efficacy, patient satisfaction, cost effectiveness, and safety

Figures & data

Table 1 Age distribution of OPAT patients treated with ceftriaxone

Age group	Number of patients	% of patients
2–3 years	4	4.1
4–14 years	15	15.5
15–45 years	73	75.3
>45 years	5	5.2
Total	97	100

Notes: The highest number of patients was in the age group 15–45 years, and the lowest number was found in the age group 2–3 years.

Abbreviation: OPAT, outpatient parenteral antimicrobial therapy.

Figure 1 Sex distribution of OPAT patients treated with ceftriaxone.

Note: In all, 59 (60.8%) males and 38 (39.2%) females were treated with ceftriaxone in the OPAT clinic.

Abbreviation: OPAT, outpatient parenteral antimicrobial therapy.

Table 2 Nationalities represented by patients

Nationalities	Number of patients	% of patients
Bahraini	84	86.6
Yemeni	5	5.15
Syrian	3	3.1
Indian	2	2.06
Kuwaiti	1	1.03
Egyptian	1	1.03
Norwegian	1	1.03
Total	97	100

Notes: It was found that the majority of patients were Bahraini (84 [86.6%]), followed by Yemini (five [5.15%]), Syrian (three [3.1%]), Indian (two [2.06%]), Kuwaiti (one [1.03%]), Egyptian (one [1.03%]), and Norwegian (one [1.03%]).

Figure 2 Nationality representation among the patients.

Table 3 Dose, duration, and route of treatment

Dose of ceftriaxone				Duration of ceftriaxone				Route of ceftriaxone
Once daily		Twice daily		3 days		>3 days		Intravenous		Intramuscular
Number of patients	% of patients	Number of patients	% of patients	Number of patients	% of patients	Number of patients	% of patients	Number of patients	% of patients	Number of patients	% of patients
67	69.1	30	30.9	89	91.8	8	8.2	89	91.8	8	8.2

Notes: All patients with acute tonsillopharyngitis treated in the OPAT clinic included in this study received ceftriaxone, either through intravenous or intramuscular routes. The duration of ceftriaxone treatment was 3 days in the majority of patients, with some receiving treatment for more than 3 days. The dose of ceftriaxone was once or twice daily.

Abbreviation: OPAT, outpatient parenteral antimicrobial therapy.

Table 4 Reasons for initiating parenteral ceftriaxone

Reasons of ceftriaxone therapy	Number of patients	% of patients
Failure of oral therapy	36	37.1
Inability to swallow	24	24.7
Failure of oral therapy and inability to swallow	21	21.6
Not documented	14	14.4
Referred from private sector	2	2.1
Total	97	100

Note: Parenteral ceftriaxone was initiated due to a variety of reasons.

Table 5 Antibiotic use before the use of ceftriaxone

Type of antibiotic	Number of patients	% of patients
Augmentin	28	51.86
Amoxicillin	7	12.96
Cefuroxime	5	9.26
Combined antibiotic	9	16.66
Others	5	9.26
Total	54	100

Notes: Oral antibiotics were used in 54 patients prior to the use of ceftriaxone. Presented are the various antibiotics that failed before ceftriaxone was initiated.

Table 6 Types of organisms isolated from patients

Organisms	Number of patients	% of patients
Group A beta-hemolytic	5	15.6
Streptococcus
Staphylococcus	5	15.6
MRSA	1	3.1
No organism detected	21	65.7
Total	32	100

Note: Throat swab cultures isolated different organisms in 32 patients.

Abbreviation: MRSA, methicillin-resistant Staphylococcus aureus.

Table 7 OPAT Short-Form Patient’s Satisfaction Questionnaire

Question number	Questionnaire	Strongly disagree	Disagree	Uncertain	Agree	Strongly agree
1	I am very satisfied with the medical care I received	1	2	3	4	5
2	Doctors are good about explaining the reason for medical tests
3	I’m usually not kept waiting for a long time when I’m at OPAT
4	I think OPAT clinic has everything needed to provide complete medical care
5	The medical care I have been receiving is just about perfect
6	During my medical visits, I’m always allowed to say everything that I think it’s important
7	When I go for medical care, they are careful to check everything when treating and examining me
8	The clinic hours when I can get medical care are convenient (good) for me
9	The medical staff that treats me known about the latest medical development
10	Doctors never expose me to unnecessary risks
11	My doctors treats me friendly and courteous
12	Those who provide me my medical care sometimes not hurry too much when they treat me
13	Places where I can get medical care are very conveniently located
14	If I have a medical question, I can reach a doctor for help without any problem
15	Doctors listen carefully to what I have to say
16	Doctors always do their best to keep me from worrying
17	I don’t find it hard to get an appointment for medical care right way
18	My doctors are very competent and well-trained

Note: This short-form questionnaire was used to assess patient satisfaction with OPAT clinic services.

Abbreviation: OPAT, outpatient parenteral antimicrobial therapy.