THE COMMUNITY HOSPITAL-BASED PARENTERAL ANTIMICROBIAL THERAPY (COHPAT) IN THAILAND: THE EXPERIENCE OF A MODEL TO CONTINUOUSLY TREAT BACTERIAL INFECTIONS AT KHLONGLUANG HOSPITAL
The treatment of infusion antimicrobials at infusion centers out of primary hospitals to complete the duration of treatment is part of antimicrobial stewardship program (ASP). The objectives of this study were 1) to determine the type of infections and of antimicrobials in patients continuously treated with injectable antimicrobials in community hospital 2) to study the causative pathogens and the laboratory monitoring during hospitalization and 3) to evaluate the clinical outcomes. This retrospective observational study was performed at Khlongluang Hospital during March to August 2020. Fifty patients who met inclusion criteria were recruited. The lower respiratory tract (46%), urinary tract infection with bloodstream infection (12%), and intra-abdominal infection (10%) were the most common. The first three rank of antimicrobials were piperacillin/tazobactam (34.9%), meropenem (25.4%) and vancomycin (11.1%), respectively. The most causative pathogens were Klebsiella pneumoniae (29.2%) and Acinetobacter baumannii (20.8%). All patients had complete blood count monitoring and 92% of studied patients were assessed renal function. Among 50 cases, there were 37 patients discharged from community hospital with good clinical outcomes whereas the remaining cases (13 cases) had treatment failure. In conclusion, this study is the first report in Thailand revealing the effectiveness of the continuous treatment of infectious diseases with injectable antimicrobials in community hospital. This study indicated that practice guideline for antimicrobial intravenous infusion at community hospitals is need for the effectiveness and safety of antimicrobial use.
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