Current practices in outpatient parenteral antimicrobial therapy programmes: an international multi-centre survey.

OBJECTIVES

This study aimed to assess the current international practices of outpatient parenteral antimicrobial therapy (OPAT).

METHODS

A multi-site cross-sectional study was conducted, using REDCap platform for survey distribution and data collection. Data analysis was performed in SPSS version 29.

RESULTS

Of the 146 OPAT responding centres serving adults, paediatrics or both, 82% have been operating for over 10 years. OPAT teams were multidisciplinary, with nurses comprising the largest proportion in 89% of centres, followed by infectious disease (ID) pharmacists (83%) and ID physicians (80%). Service activity varied widely, with 92% centres treating fewer than 100-5000 patients annually (median = 300). Home-based models of care were used by more than 85% of facilities in Australia, the UK and Spain, while 82% of Malaysian and 75% of UK centres used infusion centres. Common OPAT indications include skin and soft tissue, bone and joint, urinary tract and respiratory tract infections, with ceftriaxone and ertapenem used by over 80% of the centres. Peripherally inserted central and midline catheters were common except in Malaysia. Among enrolled centres, complex oral antimicrobial therapy supervision was higher in the UK (82%) than in Spain (77%), Australia (42%) and Malaysia (24%). Inconsistencies in guidelines supporting antimicrobial stability and dosing information were noted, with a call for more stability data on certain antimicrobials.

CONCLUSIONS

This study revealed significant variation in OPAT practice. Further study is needed to understand the reasons for these differences and whether better alignment of practice could improve patient outcomes, antimicrobial stewardship practice and resource utilization.