Outpatient Parenteral Antimicrobial Therapy Methods

Outpatient parenteral antimicrobial therapy (OPAT) enables the delivery of intravenous antibiotics to medically stable patients outside the hospital, reducing inpatient stays and supporting recovery in community settings. OPAT models include administration in infusion centres, nursing‐home environments, home visits by skilled nurses and self‐administered regimens using elastomeric pumps or ambulatory infusion devices. Central and peripheral venous access devices—most commonly peripherally inserted central catheters (PICCs) and midline catheters—facilitate prolonged therapy, while careful selection of time‐ and concentration‐dependent antimicrobials ensures therapeutic efficacy. Stability of antibiotics under variable temperatures and infusion rates is critical to maintaining potency, and structured monitoring of drug levels and catheter‐related complications underpins safety. Economic analyses have demonstrated that OPAT can be cost‐effective by avoiding hospital bed days, and patient‐reported outcomes highlight high satisfaction owing to preserved quality of life and autonomy. Nevertheless, readmission rates linked to catheter events, suboptimal drug monitoring and complex infections underscore the importance of multidisciplinary teams, robust protocols and targeted patient education to optimise outcomes.

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Outpatient Parenteral Antimicrobial Therapy Methods publication trend

The graph below shows the total number of articles in outpatient parenteral antimicrobial therapy methods across all publications each year (not limited to Nature Index journals).

Technical terms

Outpatient parenteral antimicrobial therapy (OPAT): Intravenous administration of antimicrobial agents in non-hospital settings.

Elastomeric pump: Portable device using elastic recoil to deliver controlled rates of infusion without electronic components.

Peripherally inserted central catheter (PICC): Long, thin tube inserted into a peripheral vein and advanced to a central vein for extended intravenous therapy.

Beta-lactam antibiotic: Class of antibiotics containing a β-lactam ring, including penicillins and cephalosporins, active against bacterial cell walls.

Continuous infusion: Administration method delivering a drug at a constant rate over an extended period to optimise pharmacodynamics.

References

1. Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy. Pharmaceutics (2023).
2. Stability Studies of 16 Antibiotics for Continuous Infusion in Intensive Care Units and for Performing Outpatient Parenteral Antimicrobial Therapy. Antibiotics (2022).
3. Risk factors for readmission in patients discharged with outpatient parenteral antimicrobial therapy: a retrospective cohort study. BMC Pharmacology and Toxicology (2018).
4. Clinical and cost-effectiveness, safety and acceptability of community intravenous antibiotic service models: CIVAS systematic review. BMJ Open (2017).
5. Updated good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults and children in the UK. JAC-Antimicrobial Resistance (2019).
6. Intravenous catheter-related adverse events exceed drug-related adverse events in outpatient parenteral antimicrobial therapy. Journal of Antimicrobial Chemotherapy (2018).
7. A qualitative study of patients’ feedback about Outpatient Parenteral Antimicrobial Therapy (OPAT) services in Northern England: implications for service improvement. BMJ Open (2018).