Background: Pulmonary exacerbations (PExs) are common in individuals with cystic fibrosis (CF). Data regarding outcomes of outpatient parenteral antimicrobial therapy (OPAT) in children are sparse. Methods: Retrospective data of PEx episodes treated in the hospital versus OPAT collected. Children ≤18 years were included. Outcome measures included FEV1, FVC, FEF25-75%P, time to the next PEx, and weight gain. Results: Eighty-three subjects with 290 PEx events were eligible. The hospital group had 242 and the OPAT group had 48 PEx events. The median age was 13.1 years for the OPAT and 13.4 years for the hospital group. Medicaid coverage was higher in the hospital group (82.2%) versus OPAT group (48.9%, P < 0.0001). The hospital group had lower FEV1%P on admission [72%P (interquartile range [IQR] = 59.7 and 84) versus 80%P (IQR = 70.7 and 89); P = 0.001] and at the end of treatment [86%P (IQR = 72 and 96.7) versus 92%P (IQR = 82 and 101); P = 0.003] in comparison with OPAT group. FEV1%P improved more in the hospital group, [12%P (IQR = 4 and 20)] versus in the OPAT group [8%P (IQR = 2 and 22.5); (P = 0.41)] but did not quite reach a statistically significant level. The hospital intravenous (IV) group gained more weight (P < 0.0001). There was no difference between the 2 groups in time to the first PEx (P = 0.47) and adverse events. Conclusion: OPAT was safe and comparable with hospital therapy in a select group of children with CF. Hospital IV should be considered for sicker children and families with limited resources.

中文翻译：

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囊性纤维化患儿门诊肠外抗菌治疗的结果和安全性。

背景：肺部病情加重（PExs）在患有囊性纤维化（CF）的个体中很常见。有关儿童门诊肠胃外抗菌治疗（OPAT）结果的数据很少。方法：回顾性收集医院治疗的PEx发作与OPAT的发作情况。≤18岁的儿童包括在内。结果指标包括FEV1，FVC，FEF25-75％P，下一次PEx的时间以及体重增加。结果：有290个PEx事件的八十三名受试者符合条件。医院组有242个，OPAT组有48个PEx事件。OPAT中位年龄为13.1岁，医院组中位年龄为13.4岁。医院组（82.2％）的医疗补助覆盖率高于OPAT组（48.9％，P <0.0001）。医院组入院时FEV1％P较低[72％P（四分位间距[IQR] = 59.7和84），而80％P（IQR = 70.7和89）；P = 0.001]和治疗结束时[86％P（IQR = 72和96.7）与92％P（IQR = 82和101）；与OPAT组相比，P = 0.003]。医院组的FEV1％P改善更多[12％P（IQR = 4和20）]，而OPAT组[8％P（IQR = 2和22.5）；（P = 0.41）]，但还没有达到统计学上的显着水平。医院静脉（IV）组体重增加（P <0.0001）。两组患者第一次发生PEx的时间（P = 0.47）和不良事件之间没有差异。结论：对于部分CF儿童，OPAT安全且可与医院治疗相媲美。对于病情较重的儿童和资源有限的家庭，应考虑到第四医院。医院组的FEV1％P改善更多[12％P（IQR = 4和20）]，而OPAT组[8％P（IQR = 2和22.5）；（P = 0.41）]，但尚未达到统计学上的显着水平。医院静脉（IV）组体重增加（P <0.0001）。两组患者第一次发生PEx的时间（P = 0.47）和不良事件之间没有差异。结论：对于部分CF患者，OPAT安全且可与医院治疗相媲美。对于病情较重的儿童和资源有限的家庭，应考虑到第四医院。医院组FEV1％P改善[12％P（IQR = 4和20）]，而OPAT组[8％P（IQR = 2和22.5）；（P = 0.41）]，但还没有达到统计学上的显着水平。医院静脉（IV）组体重增加（P <0.0001）。两组患者第一次发生PEx的时间（P = 0.47）和不良事件之间没有差异。结论：对于部分CF患者，OPAT安全且可与医院治疗相媲美。对于病情较重的儿童和资源有限的家庭，应考虑到第四医院。47）和不良事件。结论：对于部分CF患者，OPAT安全且可与医院治疗相媲美。对于病情较重的儿童和资源有限的家庭，应考虑到第四医院。47）和不良事件。结论：对于部分CF患者，OPAT安全且可与医院治疗相媲美。对于病情较重的儿童和资源有限的家庭，应考虑到第四医院。