Abstract：
Vancomycin is commonly used in outpatient parenteral antimicrobial therapy (OPAT) of Gram-positive infections. Therapeutic drug monitoring and adverse event monitoring pose a challenge. Outcome data of vancomycin in OPAT (vOPAT) are limited. The study aim was to report the safety and efficacy of a structured vOPAT program implemented in the University Hospitals Leuven. The program provides continuous elastomeric infusion of vancomycin at home with biweekly follow-up at the outpatient clinic. Demographics, clinical, biochemical and treatment parameters, target attainment parameters and clinical outcomes were recorded. An e-survey was conducted to assess patient satisfaction. Thirty-five vOPAT episodes in 32 patients were included. During 206 follow-up consultations, 203 plasma concentration measurements were registered with a median vancomycin plasma concentration of 22.5 mg/L (range 6.6-32.0). The majority of concentrations (68.5%) were within the therapeutic range (20.0-25.0 mg/L). Adverse event rates, including drug- (5.7%) and catheter-related (5.7%) events, were low. For 32 vOPAT episodes, a clinical cure rate of 100% was observed. All patients who completed the e-survey were satisfied with their vOPAT course. These findings show that a structured vOPAT program with rigorous follow-up provides safe and effective ambulatory treatment of patients with vancomycin in continuous infusion.
摘要：
万古霉素通常用于革兰氏阳性感染的门诊肠胃外抗菌治疗（OPAT）。治疗药物监测和不良事件监测构成了挑战。万古霉素在OPAT（vOPAT）中的结果数据有限。该研究旨在报告鲁汶大学医院实施的结构化vOPAT计划的安全性和有效性。该计划在家中提供万古霉素的连续弹性输注，并在门诊进行双周随访。人口统计,临床,生化和处理参数，记录目标达成参数和临床结果.进行电子调查以评估患者满意度。包括32例患者的35次vOPAT发作。在206次后续协商中，记录203个血浆浓度测量值，万古霉素血浆浓度中位数为22.5mg/L（范围6.6-32.0）。大多数浓度（68.5％）在治疗范围内（20.0-25.0mg/L）。不良事件发生率,包括药物（5.7%）和导管相关（5.7%）事件，很低。对于32个vOPAT情节，观察到100%的临床治愈率。完成电子调查的所有患者对他们的vOPAT课程感到满意。这些发现表明，具有严格随访的结构化vOPAT计划为连续输注万古霉素的患者提供了安全有效的动态治疗。
