Implementation of a Collaborated Antimicrobial Stewardship Program and Outpatient Parenteral Antimicrobial Therapy (OPAT) Unit-driven Monoclonal Antibody Therapy Program for COVID-19 at an NYC Hospital. (May 2022)

• Record Type: Journal Article
• Authors: Rodriguez, George D.; Wu, Yuexiu; Karnik, Krupa; Ruddy, Samantha; Kula, Anna; Warren, Nathan; Yashayev, Roman; Sajid, Fizza; Prasad, Nishant; Yoon, James; Turett, Glenn; Yung, Lok; Urban, Carl; Lee, Chan-Ho; Abraham, Jessie; Cooke, Joseph T; Sharma, Manish; Jaffer, Amir; Segal-Maurer, Sorana
• Is Part Of: International journal of infectious diseases. Volume 118(2022)
• Page Start: 214
• Page End: 219
• Publication Date: 2022-05
• Subjects: Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2022.02.056
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: COVID-19 monoclonal antibodies are safe and efficacious in mild-to-moderate disease. Implementation of a comprehensive program requires a multidisciplinary team to optimize efficiency and outcomes. Antimicrobial Stewardship Programs can facilitate and coordinate access to treatment. Outpatient parenteral antimicrobial therapy units are ideal to deliver treatment. Abstract: Objectives: This study aimed to assess the processes and clinical outcomes of a joint collaboration between Antimicrobial Stewardship Program (ASP) and the outpatient parenteral antimicrobial therapy (OPAT) unit for delivery of monoclonal antibody therapy for mild-to-moderate COVID-19. Methods: We carried out a retrospective, interim analysis of our COVID-19 monoclonal antibody therapy program. Outcomes included clinical response, incidence of hospitalization, and adverse events. Results: A total of 175 patients (casirivimab-imdevimab, n = 130; bamlanivimab, n = 45) were treated between December 2020 and March 1, 2021. The median time from symptom onset was 6 (IQR 4, 8) days at time of treatment. Of 135 patients available for follow-up, 71.9% and 85.9% of patients reported symptom improvement within 3 and 7 days of treatment, respectively. A total of 9 (6.7%) patients required COVID-19–related hospitalization for progression of symptoms, all within 14 days of treatment. A total of 7 (4%) patients experienced an infusion-related reaction. Conclusions: ASP-OPAT collaboration is a novel approach to implement an efficient and safe monoclonal antibody therapy program for the treatment of mild-to-moderate COVID-19.