Why this matters
- Consider expanding OPAT for IE patients lacking difficult-to-treat microorganisms (requiring complicated antibiotic combinations), or presenting with clinical, echocardiographic or postsurgical complications that resolve shortly postonset.
- Recommendations to expand indication should be restricted to centers with established OPAT programs.
- 429 OPAT, 1003 home-based antibiotic treatment (HBAT) patients.
- 57.1%, 27.3%, 18.6% OPAT patients, respectively, had native, prosthetic, pacemaker/defibrillator IE.
- Most common causative pathogens in OPAT group were viridans group streptococci (18.6%), coagulase-negative staphylococci (14.5%).
- Only 21.7% fulfilled IDSA criteria.
- 29% vs 37.5% OPAT, HBAT patients, respectively, had new-onset/worsening heart failure.
- Median length of antibiotic treatment, 42.0 (interquartile range, 32-54) vs 42.0 (29-45) days, OPAT, HBAT.
- No significant differences in readmission 3-month postdischarge (10.9% vs 10%, OPAT, HBAT, respectively); 1-year mortality was higher in HBAT patients (12.5% vs 7.7%, OPAT; P=.004).
- Analysis of data from the multicenter Spanish GAMES cohort, comparing outcomes of OPAT vs HBAT for IE.
- Funding: Ministerio de Sanidad y Consumo of Spain, others.
- Retrospective design.
- Patient management heterogeneity.