Descriptive Epidemiology and Trends of Community Parenteral Antimicrobial Therapy Utilization Among Solid Organ Transplant Recipients at a High Volume Transplant Center 2008 to 2014.
Infectious Diseases, Cleveland Clinic, Cleveland, OH.
Meeting: 2016 American Transplant Congress
Abstract number: D104
Keywords: Infection, Length of stay, Outpatients, Viral therapy
Session Information
Session Name: Poster Session D: Fungi, PJP, Mycobacteria, Infection Risk Factors, Vaccination and Donor Derived Infections
Session Type: Poster Session
Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
INTRODUCTION: Solid organ transplant (SOT) recipients may benefit from community-based parenteral anti-infective therapy (CoPAT). Limited data are available. CoPAT may help reduce LOS. As a large SOT center where all discharged CoPAT recipients are supervised by infectious disease (ID), this affords a unique opportunity for robust data.
OBJECTIVE: To provide updated descriptive epidemiologic data on CoPAT use in SOT recipient care between 2008-2014; including comparison to our general CoPAT data.
METHODS: The ID Department maintains a database of all Cleveland Clinic CoPAT patients. Query of this database allows for several descriptive elements of CoPAT use in this patient population.
RESULTS:
Comparison Courses:Top 10 antimicrobials (abx) general CoPAT:SOT CoPAT 2008-2014
| Abx | All CoPAT (% of total CoPAT) | SOT CoPAT (% of total SOT CoPAT) |
| Vancomycin | 7793 (26) | 423 (19.7) |
| Piperacillin/Tazobactam | 2755 (9.3) | 271 (12.6) |
| Daptomycin | 2053 (6.9) | 242 (11.3) |
| Ceftriaxone | 1810 (6.1) | 162 (7.5) |
| Oxacillin/Nafcillin | 1782 (6.0) | 40 (1.9) |
| Meropenem/Imipenem | 1432 (4.8) | 250 (11.6) |
| Ertapenem | 1288 (4.3) | 136 (6.3) |
| Ampicillin/Sulbactam | 840 (2.8) | 0 (0) |
| Micafungin | 521 (1.7) | 88 (4.1) |
| Tigacycline | 506 (1.7) | 95 (4.4) |
| Total CoPAT courses | 29,557 | 2149 |
SOT CoPAT represent 7.3% of total CoPAT courses at our institution.
Number of Courses: Top 10 abx for SOT CoPAT 2008-2014
| Abx / Year | 2014 | 2011 | 2008 | Mean 2008-2014 | % CoPAT per SOT | Range |
| Vancomycin | 41 | 49 | 59 | 58 | 11.2 % | 41-71 |
| Piperacillin/Tazobactam | 25 | 27 | 30 | 36 | 7.0 % | 25-55 |
| Meropenem/Imipenem | 23 | 44 | 39 | 34 | 6.6 % | 22-47 |
| Daptomycin | 14 | 45 | 31 | 33 | 6.4 % | 14-45 |
| Ganciclovir | 24 | 30 | 36 | 29 | 5.6 % | 24-36 |
| Ceftriaxone | 29 | 8 | 25 | 23 | 4.4 % | 8-29 |
| Ertapenem | 23 | 8 | 6 | 19 | 3.8 % | 6-32 |
| Tigecycline | 4 | 5 | 11 | 14 | 2.6 % | 5-19 |
| Micafungin | 11 | 20 | 8 | 13 | 2.5 % | 5-20 |
| Cefepime/Ceftazidime | 11 | 4 | 5 | 12 | 2.4 % | 4-24 |
| Total SOT | 487 | 494 | 516 | 517 | 487-560 |
CONCLUSION: While vancomycin is leading CoPAT abx for general and SOT use; abx for Gram-negative coverage and antiviral abx are more common in SOT recipients. CoPAT use is uncommon in SOT (less than 15% of SOT require CoPAT). Trends over time in SOT CoPAT utilization inform practice trends, and allow for utilization review.
CITATION INFORMATION: Mawhorter S, Shrestha N. Descriptive Epidemiology and Trends of Community Parenteral Antimicrobial Therapy Utilization Among Solid Organ Transplant Recipients at a High Volume Transplant Center 2008 to 2014. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Mawhorter S, Shrestha N. Descriptive Epidemiology and Trends of Community Parenteral Antimicrobial Therapy Utilization Among Solid Organ Transplant Recipients at a High Volume Transplant Center 2008 to 2014. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/descriptive-epidemiology-and-trends-of-community-parenteral-antimicrobial-therapy-utilization-among-solid-organ-transplant-recipients-at-a-high-volume-transplant-center-2008-to-2014/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress