Table 6

Reasons for hospital readmission from 251 episodes of paediatric outpatient parenteral antimicrobial therapy (OPAT)

Patient no. (episode)OPAT reasonReadmission reasonOutcome
1Mycobacterial CVC tunnel site infection in child with short gutLeaking CVC—admitted for CVC replacement (line complication)Returned to HITH after 5 days
2Inguinal lymphadenitisIncreasing lymph node size—admitted for USS followed by incision and drainage (inadequate improvement)Returned to HITH after 2 days
3CVC infection (Bacillus cereus) in child with haemophiliaOngoing positive CVC blood cultures despite appropriate antibiotics—admitted for CVC removal (inadequate improvement)No further OPAT—discharged off antibiotics
4Vertebral osteomyelitis/discitisPICC line dislodged—admitted for PICC line replacement (line complication)Returned to HITH after 5 days
5 (1st)Postsurgical deep wound infectionLarge serous discharge from wound—admitted for observation (inadequate improvement)Returned to HITH after 3 days
5 (2nd)Postsurgical deep wound infectionPleuritic chest pain—admitted for investigation of pulmonary embolism (negative); diagnosed likely viral (not OPAT-related)Returned to HITH after 2 days
6 (1st)DiscitisFever—admitted for repeat MRI (improved); hand, foot and mouth lesions developed the next day (not OPAT-related)Returned to HITH after 2 days
6 (2nd)DiscitisFever and blocked line—admitted for observation and CVC removal, coryzal symptoms the next day (line complication)No further OPAT—discharged on oral antibiotics
7DiscitisNight sweats—admitted for investigation; cultures negative but replaced CVC (line complication)Returned to HITH after 3 days
8CVC infection (Escherichia coli) in child with short gutNon-specifically unwell but afebrile on final day of antibiotics—admitted for observation; diagnosed likely viral (not OPAT-related)No further OPAT—discharged off antibiotics
9CVC infection (Staphylococcus aureus) in child with Ewing's sarcomaBleeding from port site and low platelets—admitted for nitrous gas to access port and platelet transfusion (related to underlying condition)Returned to HITH after 6 hours
  • HITH, hospital-in-the-home; CVC, central venous catheter PICC, peripherally inserted central catheter.