Maaskant Jolanda M, de Vries Tessa, Volle Laura, Jamaludin Faridi S, Geerlings Suzanne E, Sigaloff Kim C E
Department of Internal Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
Amsterdam Public Health, Amsterdam, The Netherlands.
Infection. 2025 May 12. doi: 10.1007/s15010-025-02549-1.
This study aimed to provide a comprehensive overview of the existing literature on Self-administered Outpatient Parenteral Antimicrobial Therapy (S-OPAT), focusing on safety and clinical outcomes, factors influencing these outcomes, and the experiences of patients and caregivers.
We searched the databases MEDLINE, CINAHL, Embase and Cochrane library. Publications were included if they reported on the clinical outcomes, safety, and/or experiences of patients and caregivers with S-OPAT. Study selection and data extraction were performed independently by two reviewers. Quantitative and qualitative data were summarized in data charting forms.
Forty-four studies were included: 41 primary studies, 2 systematic reviews and 1 clinical guideline. Clinical outcomes were reported in 17 and safety in 23 primary studies. Eleven studies compared S-OPAT to other OPAT delivery models. These studies showed that all models were generally comparable regarding clinical outcomes, but two studies reported an increased number of adverse events with S-OPAT. Nine studies, exploring a total of 7 potential risk factors, identified older age, comorbidities and Staphylococcus aureus infections as contributors to adverse events. The results of 14 studies on patient-centred outcomes showed that patients and caregivers considered S-OPAT a suitable alternative to other OPAT delivery models.
We conclude that S-OPAT is a viable model of care, demonstrating favourable clinical outcomes, although some safety concerns have been reported. The growing care demand now and in the future urges further development of S-OPAT care. Gaps of knowledge still exist, and we provide recommendations for future research.
本研究旨在全面概述关于自我管理的门诊肠外抗菌治疗（S-OPAT）的现有文献，重点关注安全性和临床结局、影响这些结局的因素以及患者和护理人员的体验。
我们检索了MEDLINE、CINAHL、Embase和Cochrane图书馆数据库。如果出版物报道了S-OPAT患者和护理人员的临床结局、安全性和/或体验，则将其纳入。研究选择和数据提取由两名评审员独立进行。定量和定性数据以数据图表形式进行总结。
纳入了44项研究：41项原始研究、2项系统评价和1项临床指南。17项原始研究报告了临床结局，23项报告了安全性。11项研究将S-OPAT与其他肠外抗菌治疗模式进行了比较。这些研究表明，所有模式在临床结局方面总体上具有可比性，但有两项研究报告S-OPAT的不良事件数量增加。9项研究共探讨了7个潜在风险因素，确定年龄较大、合并症和金黄色葡萄球菌感染是不良事件的促成因素。14项关于以患者为中心的结局的研究结果表明，患者和护理人员认为S-OPAT是其他肠外抗菌治疗模式的合适替代方案。
我们得出结论，S-OPAT是一种可行的护理模式，尽管有一些安全性问题的报道，但显示出良好的临床结局。当前和未来不断增长的护理需求促使S-OPAT护理进一步发展。知识差距仍然存在，我们为未来的研究提供了建议。
