Outpatient parenteral antibiotic therapy in patients with haematological malignancies - A pilot study of an early discharge strategy

The objectives of this study were to estimate the feasibility of a self-adm inistration outpatient parenteral antibiotic therapy (OPAT) model, to recor d the complication rate and to estimate patient acceptance during the OPAT period in patients with acute leukaemia (AL) or aggressive non-Hodgkin lymp homa (NHL). Patients were trained to administer the antibiotic infusions th emselves, via their central venous access device, according to a checklist and step-by-step instructions. Study-specific questionnaires were used to e valuate patient acceptance. Eleven patients [AL (n=8) and NHL (n=3), median age 51 years, range 29-66] participated in the education programme and sub sequent OPAT during ten episodes of documented infection and six episodes o f fever of unknown aetiology. All patients had assessment of the infectious episode and initial parenteral antibiotic therapy in the hospital before t hey continued self-administration at home. The median education time was 3 h (range 0.75-4..5). The patients could stay at home for 4 days (median, ra nge; 1-12) with ongoing intravenous antibiotic therapy instead of being hos pitalised. None of the patients developed recurrent fever. All patients rep orted that OPAT was of great value and they would favour OPAT again during subsequent antibiotic therapy. In conclusion, the results of this pilot ser ies suggest that OPAT, in this setting, is a safe alternative during the la st days of an episode of fever / infection. All patients were satisfied ove rall, and none was readmitted.