Inpatient and outpatient parenteral antimicrobial therapy: a cost analysis of care transition




Objective: To analyse the cost reduction of antimicrobial therapy in the short and long term, during the transition from hospital treatment to home care in the perspective of a healthcare provider. Methods: A selection of antibiotics was carried out comparing the recommendation of the Brazilian Guideline for Parenteral Antimicrobial Therapy (OPAT) and the standardization list of a specialized home care service. Then, were quantifield the direct costs of pharmacological therapy and supportive care for inpatient hospital treatment and home care program based on paid events by the health insurance company in the year 2022. Results: The lowest cost treatment has been associated with the use of Gentamicin, 5 days therapy amounted to R$ 178,98 and 42 days to R$ 532,85 in the home care modality, while in the hospital it ranged from R$ 1.782,08 the treatment for 5 days and R$ 2.337,08 for 42 days. The highest one was the drug Linezolid, which amounted R$ 487,29 for 5 days and R$ 2.620,71 for 42 days with administration at home, and in the hospital it had a cost of R$ 4.118,58 for 5 days and R$ 21.963,68 for 42 days. Aminoglycosides have a profile of little variability in the cost with the increase in days, while other drugs show a significant increase in the cost difference in extended treatment, highlighting Linezolid and Cephalosporins. Conclusion: Antimicrobial therapy proved to be economically favorable for home care in all scenarios, being a strong argument for early dehospitalization.


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Sociedade Brasileira de Infectologia. Diretrizes Brasileiras para Terapia Antimicrobiana Parenteral Ambulatorial (Outpatient Parenteral Antimicrobial Therapy- OPAT). AMB. 2020;1- 44.

PALADINO, AJ; PORETS, D. Outpatient Parenteral Antimi- crobial Therapy Today. Clinical Infectious Diseases 2010; 51(S2):S198–S208.

TICE, AD. et al. Practice Guidelines for Outpatient Parenteral Antimicrobial Therapy. Clinical Infectious Diseases 2004; 38:1651–72.

CHAPMAN, ALN; et al. Good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults in the UK: a consensus statement. J Antimicrob Chemother 2012; 67:1053–1062. doi:10.1093/jac/dks003

AKHAVIZADEGAN, H; HOSAMIRUDSARI, H; PIRROTI, H; AKBARPOUR, S. Antibiotic resistance: a comparison. Between inpatient and outpatient uropathogens. EMHJ – Vol. 27 No. 2 – 2021; 124-130.

GILCHRIST M., SEATON R.A. Outpatient parenteral antimicro- bial therapy and antimicrobial stewardship: challenges and checklists. Journal of Antimicrobial Chemotherapy. 2015; 70: 965–970.

EOGHAN CHARLES WILLIAM FARMER & RONALD ANDREW SEATON (2020): Recent innovations and new applications of outpatient parenteral antimicrobial therapy, Expert Review of Anti-infective Therapy, DOI:10.1080/14787210.2020.181056

BERREVOETS MAH, et al. Quality of outpatient parenteral antimicrobial therapy (OPAT) care from the patient’s perspective: a qualitative study. BMJ Open 2018;8:e024564. DOI:10.1136/bmjopen-2018-024564

BUGEJA S.J., STEWART D.,VOSPER H. Clinical benefits and costs of an outpatient parenteral antimicrobial therapy ser- visse. Research in Social and Administrative Pharmacy. 2021; 1551-7411.

WEN WEN, et al. Efficacy and safety of outpatient parenteral antibiotic therapy in patients with infective endocarditis: a meta-analysis. Rev Esp Quimioter 2022;35(4): 370-377.

Rajaratnam D, Rajaratnam R. Outpatient Antimicrobial Therapy for Infective Endocarditis is Safe. Heart, Lung and Cir- culation (2020),

Brasil. DIRETRIZES METODOLÓGICAS: Diretriz de Avaliação Econômica. Ministério da saúde. 2014; 2: 134.

SULEYMAN, G; KENNEY, R; ZERVOS, MJ; WEINMANN, A. Safety and efficacy of outpatient parenteral antibiotic therapy in an academic infectious disease clinic. J Clin Pharm Ther. 2017 Feb;42(1):39-43. doi: 10.1111/jcpt.12465.

MITCHELL, ED; CZOSKI MURRAY, C; MEADS, D; MINTON,J; WRIGHT, J; TWIDDY, M. Clinical and cost-effectiveness, safety and acceptability of community intravenous antibiotic service models: CIVAS systematic review. BMJ Open 2017;7:e013560. doi:10.1136/bmjopen-2016-013560.

CERVERA, C; et al. Safety and efficacy of daptomycin in outpatient parenteral antimicrobial therapy: a prospective and multicenter cohort study (DAPTODOM trial). Infectious Diseases, 2016. DOI: 10.1080/23744235.2016.1247292.

AZHIR, A; CHAPMAN, M. Delivery models, efficacy, safety, and cost reduction of outpatient parenteral antimicrobial therapy in British Columbia. BCMJ, v64 , n4, 2022, 160-165

CHAPMAN, ALN; et al. Updated good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults and children in the UK. JAC-Antimicrobial Resistance, v. 1, n. 2, pág. dlz026, 2019. doi: 10.1093/jacamr/dlz026

ZIMBROFF, RM; ORNSTEIN, KA; SHEEHAN, OC. Home-based primary care: A systematic review of the literature, 2010-2020. Journal of the American Geriatrics Society. v. 69, n. 10, pág. 2963-2972, 2021.

MUNIGALA, S; et al. Effect of changing urine testing orde- rables and clinician order sets on inpatient urine culture testing: Analysis from a large academic medical center. Infection Control & Hospital Epidemiology. v.40, n.3, p281 – 286. 2019 doi:

BARLAM, TF; et al. Executive Summary: Implementing an An- tibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. Clinical Infect Disease. v. 62, n. 10, pág. 1197-1202, 2016. doi:10.1093/cid/ciw217



How to Cite

DENARDIN IC, ALVES TB, CUNHA MA, SILVA JF. Inpatient and outpatient parenteral antimicrobial therapy: a cost analysis of care transition. Rev Bras Farm Hosp Serv Saude [Internet]. 2024Jan.8 [cited 2024Feb.22];14(4):975. Available from: