Outcome and complications of outpatient parenteral therapy in pediatric emergency utilizing only peripheral vascular access: A retrospective descriptive study

Objectives: To describe the cure and complication rates of outpatient parenteral therapy (OPT) utilizing only peripheral vascular access.

Methods: Using a retrospective descriptive study design, we reviewed the medical charts for children aged up to 15 years old who had been discharged from the emergency department into the care of the OPT unit from January 2018 to April 2019. The primary outcomes were cure and complication rates.

Results: Out of 814,150 visits, 2,788 (0.34%), accounting for 2,126 patients, were managed in the OPT unit. The majority had 2 days of symptoms, and 26.4% had comorbidities. Most patients started the treatment for suspected sepsis and suspected or confirmed urinary tract infections. The total days of therapy for all patients were 3,663. Cephalosporins were used for 75%, mostly ceftriaxone. Most patients completed the IV therapy within 2 days, 2.8% of cases required a change of antibiotics. Readmission avoidance and full recovery were achieved in 99.3%, and 0.7% needed readmission. All patients had peripheral vascular access. Complications occurred in 21%. Most were related to vascular access, but more than 80% were managed by one-time IV cannula re-insertion, and only 0.5% had treatment modification because of these complications.

Conclusion: For carefully selected patients in the pediatric emergency, outpatient parenteral therapy seems effective, safe with manageable complications, and may result in less family disturbance than hospital admission.