The Impact of COVID-19 on Outpatient Intravenous Antimicrobial Therapy (OPAT) in Physician Office Infusion Centers (POICs)
SUGAR LAND, TX – (February 16, 2022) The coronavirus disease 2019 (COVID-19) pandemic dramatically affected the provision of healthcare in the U.S. with sharp declines in routine and elective healthcare services. A study evaluated how COVID-19 impacted the provision of Outpatient Antimicrobial Therapy (OPAT) in 14 Physician Office Infusion Centers (POICs) nationwide, comparing patients treated in the first seven months of 2019 with those in the same period during 2020.
In this study, the authors found a 25% overall decline of new OPAT patients from 2019 to 2020. The decline in patients began in March 2020, reaching its lowest level in May with a 41% drop from January. OPAT patients began to rebound in June, but pre-COVID levels were still not recovered by July. These findings align with the COVID-19 timeline.
Comparing the 2019 to 2020 data, patients treated shared similar characteristics in most categories. Age differed significantly with more patients over 65 treated in 2020 during the pandemic than in 2019 (43% vs. 36%, p<0.001). The distribution of infection types remained proportional between years, with bone and joint infections predominant. The overall antimicrobial usage by drug class was similar except for extended-spectrum cephalosporins, which showed a significant increase from 9.6% in 2019 to 11.4% in 2020, driven by an increase in the use of cefepime in 2020. It was also noted that significantly fewer patients completed OPAT in 2020 versus 2019 (85.9% vs. 88.3%, p=0.021) due to more early discontinuations, switches to oral therapy, and transfer of care of home health and skilled facilities. However, the overall length of OPAT was comparable by year.
The key findings of this study conclude that OPAT provided through Infectious Disease POICs experienced a substantial decrease of new patients from January to July 2020 compared to 2019. Despite the decline of OPAT in the POICs, the overall distribution of patient demographics, location prior to OPAT, and infection types were similar between years. Most importantly, the 14 POICs continued to stay open and treat patients during the pandemic even with declines in new patients.
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IDWeek is the joint annual meeting of the Infectious Diseases Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), the HIV Medical Association (HIVMA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP). Celebrating its 10th anniversary, IDWeek 2021 was a virtual conference that took place from September 29 to October 3, 2021.
Clifford P Martin, MD, Robin H Dretler, MD, FIDSA, Jorge R Bernett, MD, Barry Statner, MD, FRCPC, FIDSA, Thomas K Sleweon, MD, Quyen Luu, MD, Richard C Prokesch, MD, FACP, FIDSA, Kent Stock, MD, Claudia P Schroeder, PharmD, PhD, Thomas C Hardin, PharmD, Lucinda J Van Anglen, PharmD, 597. The Impact of COVID-19 on Outpatient Intravenous Antimicrobial Therapy (OPAT) in Physician Office Infusion Centers (POICs), Open Forum Infectious Diseases, Volume 8, Issue Supplement_1, November 2021, Page S402, https://doi.org/10.1093/ofid/ofab466.795