Castillo-Fernández, NereaMartínez Pérez-Crespo, Pedro MaríaSalamanca-Rivera, ElenaHerrera-Hidalgo, LauraAlarcón, Arístides deNavarro-Amuedo, María DoloresGutiérrez Gutiérrez, BelénRodríguez-Baño, JesúsLópez-Cortés, Luis E.2024-02-052024-02-052023Castillo-Fernández, N., Martínez Pérez-Crespo, P.M., Salamanca-Rivera, E., Herrera-Hidalgo, L., Alarcón, A.d., Navarro-Amuedo, M.D.,...,López-Cortes, L.E. (2023). Conventional hospitalization versus sequential outpatient parenteral antibiotic therapy for Staphylococcus aureus bacteremia: post-hoc analysis of a multicenter observational cohort. Antibiotics, 12 (1), 129. https://doi.org/10.3390/antibiotics12010129.2079-6382https://hdl.handle.net/11441/154601It is not known whether sequential outpatient parenteral antimicrobial (OPAT) is as safe and effective as conventional hospitalization in patients with S. aureus bacteremia (SAB). A post-hoc analysis of the comparative effectiveness of conventional hospitalization versus sequential OPAT was performed in two prospective Spanish cohorts of patients with S. aureus bacteremia. The PROBAC cohort is a national, multicenter, prospective observational cohort of patients diagnosed in 22 Spanish hospitals between October 2016 and March 2017. The DOMUS OPAT cohort is a prospective observational cohort including patients from two university hospitals in Seville, Spain from 2012 to 2021. Multivariate regression was performed, including a propensity score (PS) for receiving OPAT, stratified analysis according to PS quartiles, and matched pair analyses based on PS. Four hundred and thirteen patients were included in the analysis: 150 in sequential OPAT and 263 in the full hospitalization therapy group. In multivariate analysis, including PS and center effect as covariates, 60-day treatment failure was lower in the OPAT group than in the full hospitalization group (p < 0.001; OR 0.275, 95%CI 0.129–0.584). In the PS-based matched analyses, sequential treatment under OPAT was not associated with higher 60-day treatment failure (p = 0.253; adjusted OR 0.660; % CI 0.324–1.345). OPAT is a safe and effective alternative to conventional in-patient therapy for completion of treatment in well-selected patients with SAB, mainly those associated with a low-risk source and without end-stage kidney disease.application/pdf14 p.engAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/Outpatient parenteral antimicrobial therapyStaphylococcus aureusBacteremiainfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccesshttps://doi.org/10.3390/antibiotics12010129