{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T03:16:02Z","timestamp":1773803762308,"version":"3.50.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Outpatient parenteral antimicrobial therapy (OPAT) has many benefits, yet factors contributing to treatment failure are not well understood. This study aimed to identify risk factors for OPAT failure by comparing successful patients to those failing therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Adult patients referred and discharged to receive OPAT in the home from August 2019 and May 2021 were included. Patients were excluded if they received OPAT at a nonhome location or had creatinine clearance less than 30\u2005mL\/min. Patient demographics, as well as admission-related information, were collected. The primary composite outcome was OPAT failure defined as infection nonresolution or new infection, medication modification, or hospital readmission. Bivariate followed by multivariate analysis was used to identify factors that increased a patient's risk of failing therapy. Additional analysis examined predictors of loss to follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 823 patients included, 588 (71.4%) successfully completed therapy with 195 (23.7%) experiencing failure. Forty (4.9%) patients were lost to follow-up. Of the failures, 109 (55.9%) experienced readmission, 63 (32.3%) experienced new or persistent infection, and 23 (11.8%) required therapy modification. Factors associated with failure included infection with vancomycin-resistant Enterococcus (odds ratio [OR]: 4.42, 95% confidence interval [CI] [1.01\u201319.29]), oxazolidinone treatment (OR: 4.92, 95% CI [1.90\u201312.82]), and increasing numbers of infusions (OR: 1.16, 95% CI [1.04\u20131.30]). Patients living further from the clinic were more likely to be lost to follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Simplifying home-based antimicrobial regimens may improve OPAT outcomes. Early identification of risk factors for OPAT treatment failure and loss to follow-up can optimize patient management and reduce adverse outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf459","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T18:13:16Z","timestamp":1754071996000},"source":"Crossref","is-referenced-by-count":2,"title":["Risk of Treatment Failure in Outpatient Parenteral Antimicrobial Therapy From an Academic Medical Center in Kentucky"],"prefix":"10.1093","volume":"12","author":[{"given":"Kaylee","family":"Worsham Behal","sequence":"first","affiliation":[{"name":"Department of Pharmacy, University of Tennessee Medical Center , Knoxville, Tennessee ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bobbi Jo","family":"Stoner","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Kentucky HealthCare , Lexington, Kentucky ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aric","family":"Schadler","sequence":"additional","affiliation":[{"name":"Kentucky Children's Hospital, University of Kentucky HealthCare , Lexington, Kentucky ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna","family":"Burgess","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Kentucky HealthCare , Lexington, Kentucky ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David S","family":"Burgess","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3716-5361","authenticated-orcid":false,"given":"Ryan P","family":"Mynatt","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University of Kentucky HealthCare , Lexington, Kentucky ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"2025082211414330400_ofaf459-B1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/ciy745","article-title":"2018 Infectious Diseases Society of America clinical practice guideline for the management of outpatient parenteral antimicrobial therapy","volume":"68","author":"Norris","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2025082211414330400_ofaf459-B2","doi-asserted-by":"crossref","first-page":"e024564","DOI":"10.1136\/bmjopen-2018-024564","article-title":"Quality of outpatient parenteral antimicrobial therapy (OPAT) care from the patient's perspective: a qualitative study","volume":"8","author":"Berrevoets","year":"2018","journal-title":"BMJ Open"},{"key":"2025082211414330400_ofaf459-B3","first-page":"55","article-title":"Current status 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challenges and checklists","volume":"70","author":"Gilchrist","year":"2015","journal-title":"J Antimicrob Chemother"},{"key":"2025082211414330400_ofaf459-B10","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s11908-021-00766-x","article-title":"Recent updates in antimicrobial stewardship in outpatient parenteral antimicrobial therapy","volume":"23","author":"Mahoney","year":"2021","journal-title":"Curr Infect Dis Rep"},{"key":"2025082211414330400_ofaf459-B11","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1093\/cid\/cit920","article-title":"Prediction model for 30-day hospital readmissions among patients discharged receiving outpatient parenteral antibiotic therapy","volume":"58","author":"Allison","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2025082211414330400_ofaf459-B12","doi-asserted-by":"crossref","first-page":"905.e1","DOI":"10.1016\/j.cmi.2018.11.009","article-title":"Developing a risk prediction model for 30-day unplanned hospitalization in 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