Outpatient parenteral antibiotic therapy | |
---|---|
Other names | OPAT |
Outpatient parenteral antibiotic therapy (OPAT) is used to administer non-oral antibiotics (usually intravenously) without the need for ongoing hospitalisation. OPAT is particularly useful for people who are not severely ill but do require a prolonged course of treatment that cannot be given in oral form.[1] OPAT is being increasingly adopted as part of antimicrobial stewardship programs; it can reduce length of stay, costs and adverse events while improving quality of life.[2] OPAT can be administered in an outpatient facility (including a provider's office, infusion center or day hospital) or at a patient's residence using an infusion pump, such as an elastomeric pump.[3][4]
Common antimicrobials used for continuous infusion are shown below:[5]
Antibiotic | Stability at 25 °C | Diluent | Existing data in elastomeric pumps |
---|---|---|---|
cefepime | 24 hours | normal saline | Yes |
ceftazidime | 48 hours | normal saline | Yes |
clindamycin | 16 days | dextrose 5% | No |
flucloxacillin | 24 hours | normal saline | Yes |
fosfomycin | 24 hours | water for injection | No |
oxacillin | 24 hours | normal saline | No |
benzylpenicillin potassium | 24–48 hours | ringer acetate | Yes |
benzylpenicillin sodium | 12–24 hours | normal saline | Yes |
piperacillin/tazobactam | 24 hours | normal saline | Yes |
vancomycin | 7 days | normal saline | Yes |
Before starting beta-lactams and vancomycin infusion, it is advisable to administer a loading dose in order to reduce time to reach target concentrations[6][7]