SHM Converge Scientific Abstract ePoster Gallery-Midlines vs. Piccs for Outpatient Parenteral Antimicrobial Therapy, Multi-Hospital Study

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This multi-hospital retrospective cohort study examined whether midline catheters or peripherally inserted central catheters (PICCs) are safer for outpatient parenteral antimicrobial therapy (OPAT). Researchers analyzed 5,335 catheters placed in hospitalized adults discharged on IV antibiotics across 69 Michigan hospitals between February 2017 and April 2023. Data came from medical record review and 30-day post-discharge follow-up calls.<br /><br />The main outcome was a composite of catheter-related adverse events, including occlusion, bloodstream infection, and venous thromboembolism (VTE). The study used Cox proportional hazards modeling to adjust for patient and catheter characteristics and to account for differences in catheter dwell time.<br /><br />Results showed that midlines had a lower rate of catheter-related adverse events than PICCs. The composite event rate was 3.63 per 1,000 catheter-days for midlines versus 5.14 for PICCs. After adjustment, midlines were associated with a significantly lower hazard of the primary outcome (hazard ratio 0.68, 95% CI 0.51–0.90; p=0.01). For individual outcomes, midlines also had lower event rates for occlusion, bloodstream infection, and VTE, although these differences were not statistically significant.<br /><br />The authors conclude that, for OPAT, midlines appear to carry a lower risk of catheter-related complications than PICCs. They note, however, that antimicrobial agents differ in their physical and chemical properties, so more research is needed to determine whether specific antibiotics influence catheter risk differently.

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David Paje

Meta Tag

Author List Anurag N. Malani, Caitlin Tatarcuk, David Paje, Elizabeth McLaughlin, Emily A. Walzl, Jennifer K. Horowitz, Lakshmi Swaminathan, Megan Heath, Scott A. Flanders, Scott Kaatz, Steven J. Bernstein, Vineet Chopra

Category Research

Concept Outpatient Parenteral Antibiotic Therapy

Concept Catheter-related Adverse Events

Concept Midline Catheter

Concept PICC Line

Concept Retrospective Cohort Study

Distinguished Non-Finalist

Presenter Organization University of Michigan

Presenting Author David Paje

Track Patient Safety

Keywords

midline catheters

PICC

outpatient parenteral antimicrobial therapy

OPAT

catheter-related adverse events

retrospective cohort study

bloodstream infection

venous thromboembolism

occlusion

hazard ratio

Outpatient Parenteral Antibiotic Therapy

Catheter-related Adverse Events

Midline Catheter

PICC Line

Retrospective Cohort Study