Outpatient Parenteral Antimicrobial Therapy in Infants Aged Under 1 Year

BACKGROUND: Literature on the safety and efficacy of outpatient parenteral antimicrobial therapy (OPAT) in infants aged under 1 year is limited. The purpose of this study was to describe OPAT use in infants aged under 1 year and evaluate whether infants aged under 90 days were at greater risk of adverse events (AEs) compared with infants aged 90 days or older. METHODS: Retrospective single-center study of patients under aged 1 year discharged on OPAT from January 2012 to June 2022. Demographic and clinical characteristics were abstracted through the electronic medical record. AEs were defined as any unplanned visit to the health care facility during OPAT. Univariable and multivariate logistic regression analyses were performed. RESULTS: Among 97 episodes of OPAT, in 88 unique patients, an AE occurred in 21.6% (21 of 97) of episodes. Of these, 12.1% (4 of 33) of infants aged under 90 days and 26.5% (17 of 64) of infants aged 90 days or older had an AE. Age under 90 days was not a significant predictor of AE. The presence of an underlying chronic condition (odds ratio, 3.53; 95% CI, 1.09-14.12; P = .049) and duration of OPAT (odds ratio, 1.06; 95% CI, 1.00-1.12; P = .042) both demonstrated an increased risk of an AE. CONCLUSIONS: Our findings suggest OPAT decisions for infants aged under 1 year should also incorporate factors such as duration of therapy and underlying conditions, rather than age alone, to help reduce the risk of OPAT.