Brown R B
Infectious Disease Division, Baystate Medical Center, Springfield, Massachusetts 01199.
Rev Infect Dis. 1991 Jan-Feb;13 Suppl 2:S147-51. doi: 10.1093/clinids/13.supplement_2.s147.
Outpatient intravenous antibiotic therapy (OPIVAT) requires selection of patients who are medically and psychologically stable, are capable of being trained to administer iv medications, will not abuse the iv system, and have insurance coverage. Patients with conditions such as osteomyelitis, septic arthritis, pelvic inflammatory disease, endocarditis, and skin and soft tissue infections are appropriate candidates. As clinical experience grows, patients with increasingly complex conditions are being successfully treated at home. Before OPIVAT can be utilized, mode of iv access, length of therapy, antibiotic selection, laboratory tests, and physician of record must be determined. Patients must be instructed how to handle emergencies. With appropriate training, such patients learn to properly manage drugs and equipment and to recognize complications. Patients who cannot be treated at home may be candidates for OPIVAT under direct medical supervision. Technical advances in pumps and catheters--as well as future changes in Medicare reimbursement--may greatly increase the number of patients who are capable of receiving OPIVAT.
门诊静脉抗生素治疗（OPIVAT）需要选择在医学和心理上稳定、能够接受静脉用药给药培训、不会滥用静脉系统且有保险覆盖的患者。患有骨髓炎、化脓性关节炎、盆腔炎、心内膜炎以及皮肤和软组织感染等疾病的患者是合适的人选。随着临床经验的积累，病情日益复杂的患者也在家中得到了成功治疗。在采用OPIVAT之前，必须确定静脉通路方式、治疗时长、抗生素选择、实验室检查以及负责医生。必须指导患者如何应对紧急情况。经过适当培训，这些患者学会正确管理药物和设备并识别并发症。无法在家中治疗的患者在直接医疗监督下可能适合OPIVAT。泵和导管的技术进步以及医疗保险报销的未来变化可能会大大增加能够接受OPIVAT治疗的患者数量。
