Abstract:
Purpose: To evaluate clinical outcomes, safety, patient-reported satisfaction, and cost-effectiveness of elastomeric pump-based Outpatient Parenteral Antimicrobial Therapy (OPAT) over six years at an Italian tertiary center.
Methods: This retrospective single-center study included 76 adult patients treated with continuous-infusion OPAT via elastomeric pumps between 2019 and 2024 at the University Hospital of Trieste, Italy.
Results: A total of 1,934 elastomeric pump-based OPAT days were delivered (median duration of 22.9 days). Clinical cure was achieved in 85.5% of patients; recurrence and failure occurred in 6.2% and 7.9%, respectively. Most frequent indications were skin/soft tissue and surgical site infections (25.9%), complicated urinary tract infections (22.4%), and bone/joint infections (16.4%). Pathogens were mainly Gram-negative (70.7%), including Enterobacterales (40.2%, 57.6% ESBL-producing), Pseudomonas aeruginosa (26.8%), and Staphylococcus aureus (17.1%, 28.6% methicillin-resistant S. aureus). The most used antibiotics were piperacillin/tazobactam (51.3%), cefepime (12.5%) and ceftolozane/tazobactam (7.5%). Adverse events were observed in 13.75% of treatments, primarily vascular access-related (5.7 events/1,000 OPAT-days); drug-related adverse events occurred in 7.8% of patients (3.1 events/1,000 OPAT-days). Among contacted patients (75% response rate), 83.7% expressed willingness to reuse the pump. Total OPAT costs were €62,190.64 compared to an estimated €773,600.00 for inpatient care, yielding a 92% cost reduction (€711,409 saved).
Conclusion: Elastomeric pump-based OPAT is a clinically effective, well-tolerated, and economically advantageous option for selected infections. Its integration into stewardship programs supports broader implementation within modern, sustainable infectious disease care models.
Reference:Babich S, Di Bella S, De Rivo R, Durojaiye OC, Lovecchio A, Misin A, Straciug M, Gobbo Y, Dellaluce A, Palmolungo M, Fabricci M, Di Girolamo FG, Roni C, Monticelli J. Continuous infusion OPAT via elastomeric pumps: effectiveness, safety, and cost-saving potential in a real-world Italian cohort. Infection. 2025 Oct 31. doi: 10.1007/s15010-025-02671-0. Epub ahead of print. PMID: 41171511.