Infective Endocarditis in a Hospital-at-Home Setting: A Retrospective Analysis in a Peripheral Spanish Hospital

Abstract

Infective endocarditis (IE) is a severe condition with high morbidity and mortality, and it requires long-term suppressive antibiotic therapy. Outpatient parenteral antimicrobial therapy (OPAT) has been used for a range of infectious diseases for more than 30 years, and in Spain it is used in hospital-at-home (HaH) settings. Our objectives were to describe and characterize the demographic, clinical, and microbiological features of patients admitted to an HaH setting and to assess the safety and effectiveness of OPAT. We conducted a retrospective study that included patients diagnosed with IE over a period of 8 years (2011-2018). We collected demographic and clinical features, length of hospital stay, antimicrobial treatment, microbiological profiles, and outcomes. We included 26 patients during the observation period. Their mean age was 66.5 years, and 88.5% were male. The mean hospital stay was 10.5 days, and the mean stay in the HaH setting was 31 days. A total of 6 patients required readmission due to deterioration, of whom 3 had severe mitral insufficiency. The 8 patients had symptoms of heart failure, but they were treated at home and did not require readmission. Ultimately, 12 patients recovered and were referred to a surgical unit for valvular repair and replacement on a scheduled basis. OPAT is a useful and effective tool for the management of patients diagnosed with IE in HaH settings.