OPAT Community and Outcomes: The OPAT Service Directory and National Outcomes Registry

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OPAT Community and Outcomes: The OPAT Service Directory and National Outcomes Registry

For enquiries/support:

Service Directory in Action! Can BSAC sort out daily antibiotics? GP R

OPAT Community and Outcomes: The OPAT Service Directory and National Outcomes Registry

The National OPAT Outcomes Registry Provides the most comprehensive overview of OPAT service provision across the UK & Ireland http://opatregistry.com/ Free of charge Accessible Easy to use

Enter data Value of Service NORS Bench mark Regional or National

NORS Data Support Service Expansion Improve stewardship Shared Learning Improve patient outcomes

Add, edit & review data

Data Comparisons Number of patient episodes Number of treatment days saved Antimicrobial agents used Infection Outcomes: Cured, Improved, Failed OPAT Outcomes: Success, Partial, Failed, Intermediate

NORS Reports Flexible Build Excel download Large amounts

Reports Region Service Type PIDS Adverse Agents Treatment days saved Patient episodes Event Reaction Up to 3 drugs IV +/- oral

PID Report

Number of Treatment Days Saved by PID (2017) 7000 6000 5000 4000 3000 2000 1000 0 93 14 361 Actinomycosis Aspergillosis 1285 344 Bacterial meningitis 3532 3 9 Bursitis 4668 Cellulitis 545 14 26 Cholangitis 1682 Diabetic foot infection (no 741 1183 375 139 28 1545 277 756 73 406 75 75 92 57 364 1833 46 22 Discitis/vertebral osteomyelitis - Empyema Endocarditis Hepatic abscess Intraabdominal abscess Lyme Lymphadenitis Malignant otitis externa Orbital cellulitis 6097 1962 2695 2776 Osteomyelitis - non surgical Other 119 172 15 129 14 Pelvic Abcess Pneumonia - Community 3052 Prosthetic joint - knee 1991 2320 Prosthetic joint- hip 169 18 665 30 1041 2 858 4 10 5 352 1186 1144 8 10 1643 Pyrexial of unknown origin Salmonella Sinusitis Syphilis Tonsillitis Urinary tract infection Viral infection Wound Infection - post surgical

Number of Patient Episodes by PID (2017): A-M list 800 744 700 600 526 500 400 300 322 200 100 0 5 1 15 121 37 2 1 20 1 2 78 63 53 11 12 3 154 9 55 2 17 8 3 3 1 9 Actinomycosis Appendicitis Aspergillosis Bacteraemia / blood stream infection/ Bacterial meningitis Bronchiectasis Bursitis Candidiasis Cellulitis Cerebral abscess Cholangitis Cystic fibrosis - infective episode Diabetic foot infection (no osteomyelitis) Discitis/vertebral osteomyelitis - Discitis/vertebral osteomyelitis - no Diabetic foot infection (no osteomyelitis) Empyema Encephalitis Endocarditis Epidural abscess Hepatic abscess Infected pacing box Intraabdominal abscess Line related infection - systemic Lyme Lyme (Neuro) Lymphadenitis MAI (Non-tuberculous mycobacteria) Malignant otitis externa

Number of Patient Episodes by PID (2017): M-Z list 250 200 197 193 210 150 150 157 150 100 71 102 115 56 89 83 50 0 1 2 3 7 4 16 3 8 5 3 1 1 3 2 6 33 8 10 Mastoiditis Orbital cellulitis Osteomyelitis - diabetic foot Osteomyelitis - non surgical Osteomyelitis - surgically related Other Otitis media Pelvic Abcess Periorbital cellulitis Pneumonia - Community Acquired Pneumonia - Hospital Acquired Prosthetic joint - knee Prosthetic joint - other Prosthetic joint- hip Psoas Abscess Pyrexial of unknown origin Respiratory tract infection - other Salmonella Septic arthritis Sinusitis Skin and soft tissue infection Syphilis Syphilis (Neuro) Tonsillitis Tuberculosis Urinary tract infection Vascular graft infection Viral infection VP Shunt Infection Wound Infection - post surgical

OPAT & Infection Outcomes (2017) 4500 4000 3500 3967 3503 3000 2500 2000 1500 1000 729 500 0 236 73 187 231 Success Partial success Indeterminate Failure Cure Improved Failure OPAT Outcome Infection Outcome

Adverse Reactions Report

Adverse Reactions Reported (2017) 60 50 52 40 40 39 30 27 20 14 14 13 12 10 5 6 6 0 Blood dyscrasia 0 C. Diff Diarrhoea (antibiotic induced) Hepatitis Other Rash Allergy to Dressing Infection Line migration Line occlusion Other Thrombus Drug Line

Antimicrobial Agents Report

Top 10 Antimicrobial Agents (2017) 18000 Total Treatment Days Saved Total Episodes 1800 16000 1600 14000 1400 12000 1200 10000 1000 8000 800 6000 600 4000 400 2000 200 0 0 Ceftriaxone Ceftazidime Teicoplanin Meropenem Ertapenem Daptomycin Pip/Taz Ciprofloxacin Flucloxacillin Rifampicin

Contributing Services (2017)

Image from: http://wp.wpi.edu/cdc/files/2013/09/thank-you-post-it-752x483.jpg Acknowledgments

OPAT Services contributing 2017 data Aberdeen Royal Infirmary Leeds (Adult, Teaching, Hospital site) Airedale NHS Foundation Trust (Adult, Teaching, Hospital site) Birmingham Heartlands Hospital Leeds (Adult, Specialist, Hospital site) Buckinghamshire Healthcare OPAT service Leeds (Adult, Teaching, Hospital site) Calderdale Royal Hospital (Adult, Specialist, Primary Care) County Durham and Darlington NHS Foundation Trust (Adult, Specialist, Hospital site) Great Western Hospital, Swindon (Adult, Teaching, Hospital site) Guy's and St Thomas' Hospital NHS Trust (Adult, Teaching, Hospital site) Harefield Hospital OPAT (Adult, Specialist, Hospital site) Imperial College Healthcare NHS Trust Adult OPAT Service (Adult, Teaching, Hospital site) Kettering Diabetic Foot OPAT pilot service (Adult, Specialist, Hospital site) Leeds (Adult, Teaching, Hospital site) Locala IV Team (Adult, Specialist, Primary Care) Nottingham University Hospitals NHS Trust (Adult, Teaching, Hospital site) OPAT Greater Glasgow & Clyde (Adult, Teaching, Hospital site) QA@home Portsmouth Out of Hospital Services (Adult, Teaching, Hospital site) Raigmore Hospital (Adult, Teaching, Hospital site) Royal Liverpool and Broadgreen University Hospitals Trust (Adult, Teaching, Hospital site) Royal National Orthopaedic Hospital (Adult, Specialist, Hospital site) Sheffield Children's Hospital (Paediatric Hospital site) St Mary's Hospital, Newport, Isle of Wight (Adult, Specialist, Hospital site) The James Cook University Hospital, Middlesbrough (Adult, Teaching, Hospital site) University College Hospital (Adult, Teaching, Hospital site) Wirral OPAT Service, Arrowe Park Hospital (Adult, Teaching, Hospital site) Wythenshawe Hospital, Manchester University NHS Foundation Trust (Adult, Teaching, Hospital site)

NORS Development & Testing Group Mark Gilchrist: Imperial College Healthcare NHS Trust & BSAC OPAT Co-chair Carolyn Hemsley: Guy s & St Thomas NHS Foundation Trust Matthew Laundy: St George s University Hospitals NHS Trust Sarah Logan: University College Hospital Sanjay Patel: Southampton Children s Hospital Andrew Seaton: NHS Greater Glasgow and Clyde & BSAC OPAT co-chair Sue Snape: Nottingham University Hospitals NHS Trust Claire Vallance: OPAT Greater Glasgow & Clyde

Early Adopters Airedale NHS Foundation Trust - Fiona Throp Buckinghamshire Healthcare Trust - Marie Woodley County Durham and Darlington NHS Foundation Trust - Alex Maurer Greater Glasgow & Clyde - Claire Vallance Guy's and St Thomas' NHS Foundation Trust - Carolyn Hemsley Heart of England NHS Foundation Trust - Jo Spicer Isle of Wight NHS Trust - Mel Stevens & Amanda Wilson Leeds Teaching Hospitals NHS Trust - Jane Minton Manchester University Foundation Trust - Elizabeth Wilson Portsmouth Hospitals NHS Trust - Sydnee Williams Royal Liverpool and Broadgreen University Hospitals Trust - Ian Byrom South Tees Hospitals NHS Foundation Trust - John Williams University College London Hospitals Trust Sarah Logan Wirral University Teaching Hospital NHS Foundation Trust - Sharon Bamber

Man can accomplish anything when he realises that he is a part of something bigger. A team of people who share that conviction can change the world.

Register for the BSAC Newsletter Email: mcorley@bsac.org.uk Michael Corley, Policy and Public Affairs Officer, BSAC

All Antimicrobial Agents Administered in 2017 Treatment Days Saved = 57,728 Episodes = 4,874 18000 16000 14000 12000 10000 8000 6000 4000 2000 0 Aciclovir Amikacin + Ethambutol + Amoxicillin + Daptomycin Amphotericin Aztreonam + Tobramycin Total Treatment Days Saved Total Episodes Ceftazidime Ceftazidime + Metronidazole Ceftriaxone Ceftriaxone + Ciprofloxacin + Ceftriaxone + Daptomycin Ceftriaxone + Gentamicin Ceftriaxone + Metronidazole Ceftriaxone + Teicoplanin Ciprofloxacin + Colistin Ciprofloxacin + Ertapenem + Ciprofloxacin + Linezolid + Ciprofloxacin + Teicoplanin Clindamycin Colistin Daptomycin Daptomycin + Levofloxacin Doxycycline Ertapenem + Fluconazole + Ertapenem + Linezolid + Flucloxacillin Fluconazole Fusidic Acid Imipenem Levofloxacin Linezolid + Other - Free text Meropenem Other - Free text Prothionamide Rifampicin + Teicoplanin Tigcycline Trimethoprim

Table of Top 10 Antimicrobial Agents Administered in 2017 Agent Treatment Days Saved Patient Episodes Ceftriaxone 16465 1563 Ceftazidime 3130 962 Teicoplanin 11799 666 Meropenem 1944 428 Ertapenem 4979 309 Daptomycin 3002 197 Piperacillin/ Tazobactam 1515 118 Ciprofloxacin 2117 70 Flucloxacillin 923 68 Rifampicin 2283 63

Scotland Services Contributing 2017 Data Service Treatment Days Saved Episodes Aberdeen Royal Infirmary 2192 71 OPAT Greater Glasgow & Clyde 3310 270 Raigmore Hospital 495 25 TOTAL 5997 366

England Services Contributing 2017 Data SERVICE NAME Aberdeen Royal Infirmary Airedale NHS Foundation Trust, Community IV pathway Birmingham Heartlands Hospital Buckinghamshire Healthcare OPAT service Calderdale Royal Hospital County Durham and Darlington NHS Foundation Trust OPAT Service Great Western Hospital, Swindon Guy's and St Thomas' Hospital NHS Trust Harefield Hospital OPAT Imperial College Healthcare NHS Trust Adult OPAT Service Kettering Diabetic Foot OPAT pilot service Leeds Locala IV Team Nottingham University Hospitals NHS Trust OPAT Greater Glasgow & Clyde QA@home Portsmouth Out of Hospital Services Raigmore Hospital Royal Liverpool and Broadgreen University Total Treatment Days Saved Episodes Count 2192 71 241 47 1686 173 1330 83 2696 242 736 47 483 29 2227 100 76 6 2585 113 96 4 779 43 2768 259 9801 500 3310 270 1494 923 495 25