کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3343694 1591183 2016 4 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Outpatient parenteral antimicrobial therapy for orthopedic infections – a successful public healthcare experience in Brazil
ترجمه فارسی عنوان
درمان ضدمیکروبی تزریقی سرپایی برای عفونت های ارتوپدی؛ یک تجربه موفق بهداشت و درمان عمومی در برزیل
کلمات کلیدی
درمان تزریقاتی خانگی ؛ امکانات مراقبت های سیار. عمل بهداشت و درمان عمومی؛ کورک استخوانی
موضوعات مرتبط
علوم زیستی و بیوفناوری ایمنی شناسی و میکروب شناسی ایمونولوژی و میکروب شناسی (عمومی)
چکیده انگلیسی

Treatment of orthopedic infections usually requires prolonged antimicrobial therapy, ranging from 14 days up to 6 months. Nowadays, rising levels of antimicrobial resistance demands parenteral therapy for many patients. Outpatient parenteral antimicrobial therapy (OPAT) is a modality that allows treatment out of hospital in these situations. In Brazil, where a public universal healthcare system allows full coverage for all citizens, implantation and dissemination of OPAT programs would be beneficial for patients and for the system, because it would allow a better allocation of health resources. The Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da USP (IOT) started, in July 2013, a partnership with municipal health authorities in Sao Paulo, Brazil, in order to initiate an OPAT program in which patients discharged from that hospital would be able to continue antimicrobial therapy at primary care facilities. When necessary, patients could also receive their therapy at the day-hospital located at IOT. Primary care nursing and physician staff were trained about antimicrobial infusion and peripherally inserted central catheter manipulation. An OPAT specific antimicrobial protocol was designed and a special reference and counter-reference organized. As a result, 450 primary healthcare professionals were trained. In the first year of this program, 116 patients were discharged for OPAT. Chronic and acute osteomyelitis were most frequent diagnosis. Teicoplanin, ertapenem and tigecycline were the most used drugs. Duration of treatment varied from 10 to 180 days (average 101, median 42). Total sum of days in OPAT regimen was 11,698. Only 3 patients presented adverse effects. Partnership between services of different levels of complexity allowed implantation of a safe and effective public healthcare OPAT program for treatment of orthopedic infections. This program can serve as a model for developing similar strategies in other regions of Brazil and Latin America.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Brazilian Journal of Infectious Diseases - Volume 20, Issue 3, May–June 2016, Pages 272–275
نویسندگان
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