Practice Guidelines for Outpatient Parenteral Antimicrobial Therapy

TLDR

Outpatient parenteral antimicrobial therapy (OPAT) requires coordinated teamwork, physician oversight, and tailored antimicrobial selection, including once‑daily dosing and supervised first doses, with special considerations for children. OPAT programs select antimicrobials based on hospital‑different criteria.

Abstract

other forms of therapy.These include the required teamwork, communication, monitoring, and outcome measurements (tables 3 and 4).4. The physician has a unique role on the OPAT team, which may also include nursing, pharmacy, and social services.These responsibilities include establishing a diagnosis, prescribing treatment, determining the appropriate site of care, monitoring during therapy, and assuring the overall quality of care.5. Antimicrobial selection for OPAT is different from that for therapy in the hospital.Once-daily drug administration has many advantages.Potential for adverse effects and the stability of an antimicrobial once it is mixed must be considered (tables 5-7).6.The importance of administering the first dose of an antibiotic in a supervised setting is emphasized.7. Regular clinical and laboratory monitoring of patients receiving OPAT is essential and varies with the antimicrobial chosen (table 8).8. Outcomes measures should be an integral part of any OPAT program, to assure the effectiveness and quality of care (table 9).9. Children receiving OPAT must be considered differently because of their special needs. NOTE. UTI, urinary tract infection.a Data from OPAT Outcomes Registry (available at http://www.opat.com). b Data from Susan Rehm, personal communication.Percentage of infections not recorded.