TY - DATA T1 - Economic evaluation of outpatient parenteral antimicrobial therapy: a systematic review PY - 2017/08/04 AU - Eliane Molina Psaltikidis AU - Everton Nunes da Silva AU - Joaquim Murray Bustorff-Silva AU - Maria Luiza Moretti AU - Mariângela Ribeiro Resende UR - https://tandf.figshare.com/articles/journal_contribution/Economic_evaluation_of_outpatient_parenteral_antimicrobial_therapy_a_systematic_review/5277793 DO - 10.6084/m9.figshare.5277793.v1 L4 - https://ndownloader.figshare.com/files/9035794 KW - Anti-infection agents KW - economic evaluation KW - outpatient parenteral antimicrobial therapy KW - OPAT KW - infectious diseases N2 - Introduction: Outpatient parenteral antimicrobial therapy (OPAT) consists of providing antimicrobial therapy by parenteral infusion without hospitalization. A systematic review was performed to compare OPAT and hospitalization as health care modalities from an economic perspective. Areas covered: We identified 1455 articles using 13 electronic databases and manual searches. Two independent reviewers identified 35 studies conducted between 1978 and 2016. We observed high heterogeneity in the following: countries, infection site, OPAT strategies and outcomes analyzed. Of these, 88% had a retrospective observational design and one was a randomized trial. With respect to economic analyses, 71% of the studies considered the cost-consequences, 11% cost minimization, 6% cost-benefit, 6% cost-utility analyses and 6% cost effectiveness. Considering all 35 studies, the general OPAT cost saving was 57.19% (from −13.03% to 95.47%). Taking into consideration only high-quality studies (6 comparative studies), the cost saving declined by 16.54% (from −13.03% to 46.86%). Expert commentary: Although most studies demonstrate that OPAT is cost-effective, the magnitude of this effect is compromised by poor methodological quality and heterogeneity. Economic assessments of the issue are needed using more rigorous methodologies that include a broad range of perspectives to identify the real magnitude of economic savings in different settings and OPAT modalities. ER -