A total of 26 caregivers of pediatric patients <18 years discharged between July 1, 2017, and December 31, 2017, receiving parenteral or prolonged oral antibiotics, completed a predischarge survey to identify social challenges families faced. Child-specific medical information was collected by electronic medical record review. Descriptive statistics were used to characterize social challenges. The mean patient age was 7.7 years. Infections included osteomyelitis (31%), endocarditis or infectious thrombophlebitis (19%), brain abscess or meningitis (15%), complicated pneumonia (12%), device-related infections (12%), or other (12%). Combined, patients spent 1150 days on outpatient parenteral or prolonged oral antibiotic therapy (OPAT; 390 parenteral; 760 prolonged oral antibiotic days).
Of the psychological vulnerabilities identified, economic hardship featured prominently, with 38% of caregivers having difficulty paying for food, housing, or utilities, and 12% having problems with appliances working at home. Among the caregivers, 23% reported inadequate social support, 42% reported mental health concerns, 15% reported involvement with child protective services, and 19% reported other family-related legal concerns. Difficulty getting time off work was reported by 27%, and 31% requested extra help with coordination of healthcare services. A high school degree or lower educational level was reported by 58% of caregivers.
A large number of social vulnerabilities likely impact pediatric OPAT after discharge. The identification of such vulnerabilities for pediatric OPAT patients before discharge could better enable treatment customization or prompt care coordination.
Source: Felder K, et al. IDWeek 2018. Abstract 1931.