Tratamiento de la infección respiratoria por Pseudomonas aeruginosa en pacientes adultos en hospitalización a domicilio: características clínicas y evolutivas así como análisis de los factores pronósticos de recidiva

The Comfort Theory as a Theoretical Framework Applied to a Clinical Case of Hospital at Home

The comfort theory was applied in the development of a nursing process for the clinical case of an older adult with pneumonia treated under hospital at home. It was observed that the theory is easy to apply in the domiciliary context and that it allows the implementation of a holistic care plan.

Effectiveness and safety of outpatient parenteral antimicrobial therapy in acute exacerbation of chronic obstructive pulmonary disease

AIM

We analysed the effectiveness and safety of outpatient parenteral antibiotic therapy (OPAT) in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in patients admitted to home hospitalisation units (HHU).

METHODS

Retrospective multicentre study of patients with AECOPD included in the Spanish OPAT Registry during 2 years period.

RESULTS

Twenty-seven hospitals included 562 episodes in 361 patients diagnosed COPD GOLD III-IV. The most frequently isolated pathogen was Pseudomonas aeruginosa (38%) and the most frequently used antibiotic was piperacillin-tazobactam (20%). The effectiveness of OPAT defined as the rate of improvement or recovery was 93.4%. The safety of OPAT defined as no adverse drug events and no infectious or catheter-related complications was 89.3%. Moreover, the risk of hospital readmission was not greater in patients with AECOPD aged >80 years. No differences in the effectiveness or safety were observed when OPAT was administered by patients and/or caregivers.

CONCLUSION

Patients with AECOPD who require parenteral antimicrobial therapy can be managed effectively and safely in HHU, avoiding hospital stays, readmissions and complications.