Introduction: Urinary Tract Infection (UTI) is a common childhood disease that may, at times, require the use of parenteral antibiotics.
Parenteral antibiotics was long considered a treatment reserved for the inpatient setting, Out-Patient Parenteral Antibiotic Treatment (OPAT) programs are aimed at minimizing hospitalization, thus lowering costs, discomfort and healthcare associated morbidity. The goal is to describe the treatment of children receiving OPAT for UTI in a large urgent care system.
Methods: Design: Retrospective chart review.
Setting: TEREM Emergency Medical Centers, a system of 14 urgent care centers with nationwide distribution.
Study Population: All patients aged 3m to 18y receiving OPAT for UTI`s at any of TEREM’s Jerusalem area clinics.
Results: In 2013, 1741 cases of UTI in children were diagnosed at TEREM of whom 294 (16%) received parenteral treatment. 92.9% were female; mean age was 4.79 years.
Most cases (57.1%) received a single parenteral dose, 21.4%, 15% and 6.5% received 2, 3 and 4+ doses respectively.
After parenteral treatment, 89.1% cases were discharged home with PO antibiotics, 2.4% had to be sent to the hospital and 8.5% cases did not complete the treatment. 5.4% cases presented to TEREM again within 1 month of discharge; however, none were sent to the hospital on relapse.
Discussion: Our results show a low rate of readmission. In conclusion, OPAT is a promising tool that may allow treatment of more UTI patients in the community, lowering costs and healthcare associated morbidity. Additional research is needed to confirm the efficacy and patient satisfaction from this program.
