{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T10:52:30Z","timestamp":1740135150544,"version":"3.37.3"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The outpatient parenteral antibiotic therapy (OPAT) program of Vancouver General Hospital (VGH) was supervised by emergency physicians (EPs) until 2017 when infectious disease (ID) physicians began assisting in management. We designed a retrospective study to determine whether ID involvement led to improved outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study analyzes the impact of ID involvement by comparing the mean days patients spent on OPAT with ID involvement versus EPs alone through a retrospective chart review. Secondary research objectives were to compare patient care decisions, e.g., antibiotic choice, tests ordered, and final diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no difference between the mean number of days on OPAT between physician types. Compared to historic patterns, patients seen in OPAT after increased ID consultation spent an average of 0.5 fewer days in the program. However, when grouped by the first day of ID assessment, the average total days in OPAT was closely aligned with the day of first ID assessment, implying that ID frequently discharged patients close to initial assessment. Patients seen by ID were less likely to return within one month of discharge compared to those not seen by ID. Secondary findings include ID physicians prescribing a greater range of antibiotics, providing more varied final diagnoses, prescribing antibiotics less frequently, as well as ordering more cultures, diagnostic imaging and specialist consults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The findings of this study support the hypothesis that ID involvement in OPAT programs leads to changes in care that may have beneficial outcomes for patients and the healthcare system.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12879-024-09305-0","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T05:24:53Z","timestamp":1719897893000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative analysis of the impact of infectious disease physicians on patients in the emergency department fast-track parenteral antibiotics program"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3626-6236","authenticated-orcid":false,"given":"C.","family":"McSweeney","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3136-6668","authenticated-orcid":false,"given":"T.","family":"Steiner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7189-2905","authenticated-orcid":false,"given":"J. M.","family":"Grant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,1]]},"reference":[{"issue":"S2","key":"9305_CR1","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1086\/653520","volume":"51","author":"JA Paladino","year":"2010","unstructured":"Paladino JA, Poretz D. Outpatient parenteral antimicrobial therapy today. Clin Infect Dis. 2010;51(S2):198\u2013S208. https:\/\/doi.org\/10.1086\/653520","journal-title":"Clin Infect Dis"},{"issue":"4","key":"9305_CR2","doi-asserted-by":"publisher","first-page":"f1585","DOI":"10.1136\/bmj.f1585","volume":"12","author":"ALN Chapman","year":"2013","unstructured":"Chapman ALN, Mortlock NJ, Schleis T. Outpatient parenteral antimicrobial therapy. BMJ. 2013;12(4):f1585\u20131585. https:\/\/doi.org\/10.1136\/bmj.f1585","journal-title":"BMJ"},{"key":"9305_CR3","doi-asserted-by":"crossref","unstructured":"Laupland KB, Valiquette L. Outpatient parenteral antimicrobial therapy. Can J Infect Dis Med Microbiol (24). 2013; https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3630020\/pdf\/jidmm24009.pdf","DOI":"10.1155\/2013\/205910"},{"key":"9305_CR4","doi-asserted-by":"publisher","unstructured":"Hirschmann JV, Raugi GJ. Lower limb cellulitis and its mimics: part II. Conditions that simulate lower limb cellulitis. J Am Acad Dermatol. 2012;67(2). https:\/\/doi.org\/10.1016\/j.jaad.2012.03.023","DOI":"10.1016\/j.jaad.2012.03.023"},{"key":"9305_CR5","doi-asserted-by":"publisher","unstructured":"Falagas ME, Vergidis PI. Narrative review: diseases that masquerade as infectious cellulitis. Annals of Internal Medicine. Am Coll Physicians. 2005. https:\/\/doi.org\/10.7326\/0003-4819-142-1-200501040-00011","DOI":"10.7326\/0003-4819-142-1-200501040-00011"},{"issue":"3","key":"9305_CR6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5070\/D39GN050RR","volume":"17","author":"CV David","year":"2011","unstructured":"David CV, Chira S, Eells SJ, Ladrigan M, Papier A, Miller LG, Craft N. Diagnostic accuracy in patients admitted to hospitals with cellulitis. Dermatol Online J. 2011;17(3):1. http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21426867","journal-title":"Dermatol Online J"},{"issue":"4","key":"9305_CR7","doi-asserted-by":"publisher","first-page":"ofw193","DOI":"10.1093\/ofid\/ofw193","volume":"3","author":"RM Petrak","year":"2016","unstructured":"Petrak RM, Skorodin NC, Fliegelman RM, Hines DW, Chundi VV, Harting BP. Value and clinical impact of an infectious disease-supervised outpatient parenteral antibiotic therapy program. Open Forum Infect Dis. 2016;3(4):ofw193. https:\/\/doi.org\/10.1093\/ofid\/ofw193","journal-title":"Open Forum Infect Dis"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09305-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-024-09305-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09305-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,23]],"date-time":"2024-11-23T07:12:53Z","timestamp":1732345973000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-024-09305-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,1]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["9305"],"URL":"https:\/\/doi.org\/10.1186\/s12879-024-09305-0","relation":{},"ISSN":["1471-2334"],"issn-type":[{"type":"electronic","value":"1471-2334"}],"subject":[],"published":{"date-parts":[[2024,7,1]]},"assertion":[{"value":"23 June 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 April 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All methods were carried out in accordance with relevant guidelines and regulations.All experimental protocols were approved by a Vancouver Costal Health Research Institute ethics as well as the University of British Columbia Clinical Research Ethics Board.UBC ethics number: H18-03264.VCH number: V18-03264.Informed consent was not required as per our intuition\u2019s clinical research guidelines as patient information was deidentified according to protocols for our chart review.Article 5.5 A, TCPS2, states: \u201cResearchers who have not obtained consent from participants for secondary use of identifiable information shall only use such information for these purposes if they have satisfied the REB that:a. identifiable information is essential to the research;b. the use of identifiable information without the participants\u2019 consent is unlikely to adversely affect the welfare of individuals to whom the information relates;c. the researchers will take appropriate measures to protect the privacy of individuals, and to safeguard the identifiable information;d. the researchers will comply with any known preferences previously expressed by individuals about any use of their information;e. it is impossible or impracticable to seek consent from individuals to whom the information relates; and.f. the researchers have obtained any other necessary permission for secondary use of information for research purposes.\u201dWe have satisfied these requirements as per review by the Vancouver Coastal Health Research Institute ethics review board.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"655"}}