The effect of OPAT on patient care

  • OPAT is an important step in the treatment continuum for bacteremia1-4
  • OPAT offers many patient benefits and can be tailored to meet individual needs1-4
  • Initiating appropriate antibiotic therapy promptly can help patients transition to OPAT1,5,6

Initiate appropriate therapy; transition to OPAT

Transitioning appropriate patients to OPAT7

transitioning-to-opat
  • Initiate appropriate antibiotic therapy with the goal of discharge on OPAT1,5,6
  • OPAT may also be administered in a hospital outpatient clinic and physician’s office setting, as well as in the home by a healthcare professional1,7
  • Hospital case managers can play a key role through review of the patient's total care needs and identifying those who may be discharged to OPAT8

Transitions of care in the treatment of bacteremia: a variety of settings to help meet patient needs

from-inpatient-facility

Setting of care considerations when administering antimicrobial therapy

  • Hospital inpatient
  • Availability of equipment, facilities, and medical staff for the administration and monitoring of therapy7
  • Hospital-based infusion center
  • Directly supervised therapy with the availability of medical staff and resources, if needed7
  • Requires patient transportation to the center7
  • Long-term care/skilled nursing facility
  • Provides medical resources for patients not capable of self care, who do not have satisfactory caregivers, have multiple medical problems, are undergoing rehabilitation, or are unlikely to be compliant9
  • Suitable for patients who require skilled therapy beyond infusion of antimicrobial agents9
  • Physician's office
  • Physician management and supervision of therapy7
  • Requires patient transportation to the office7
  • Home infusion by a healthcare professional
  • Allows patients who are difficult to transport (eg, limited mobility, bedridden) or do not have transportation to receive supervised therapy with skilled clinical assessments in their home1,7

General advantages of OPAT1-4


advantages-to-opat

aBased on 1998-2001 registry data from Scotland.

References:

  1. Williams DN, Rehm SJ, Tice AD, et al. Practice guidelines for community-based parenteral anti-infective therapy. Clin Infect Dis. 1997;25(4):787-801.
  2. Tice A. Outpatient parenteral antimicrobial therapy as an alternative to hospitalization. Int J Clin Pract Suppl. 1998;95:4-8.
  3. Nguyen HH. Hospitalist to home: outpatient parenteral antimicrobial therapy at an academic center. Clin Infect Dis. 2010;51(suppl 2):S220-S223.
  4. Nathwani D, Tice A. Ambulatory antimicrobial use: the value of an outcomes registry. J Antimicrob Chemother. 2002;49(1):149-154.
  5. Paul M, Kariv G, Goldberg E, et al. Importance of appropriate empirical antibiotic therapy for methicillin-resistant Staphylococcus aureus bacteraemia. J Antimicrob Chemother. 2010;65(12):2658-2665.
  6. Lodise TP, McKinnon PS, Swiderski L, et al. Outcomes analysis of delayed antibiotic treatment for hospital-acquired Staphylococcus aureus bacteremia. Clin Infect Dis. 2003;36(11):1418-1423.
  7. Tice AD. An overview of outpatient parenteral antimicrobial therapy. In: Tice AD, ed. Handbook of Outpatient Parenteral Antimicrobial Therapy. Tarrytown, NY: CRG Publishing; 2006:9-21.
  8. Heintz BH, Halilovic J, Christensen CL. Impact of a multidisciplinary team review of potential outpatient parenteral antimicrobial therapy prior to discharge from an academic medical center. Ann Pharmacother. 2011;45(11):1329-1337.
  9. Tice AD, Rehm SJ, Dalovisio JR, et al. Practice guidelines for outpatient parenteral antimicrobial therapy. Clin Infect Dis. 2004;38(12):1651-1672.