Outpatient parenteral antimicrobial therapy as an alternative to hospitalization.

Outpatient parenteral antimicrobial therapy (OPAT) has evolved because of advances in antibiotics and the advent of new technology. It provides a cost-effective means of treating seriously infected patients away from hospital. Virtually any infection can be treated on an outpatient basis and several treatment programmes have been designed. Housebound patients can be visited by a nurse who will supervise administration; infusion centres, set up in a clinic or a doctor's office, provide on-hand medical staff and the benefit of a medical facility; self-administration provides autonomy for patient and family and is the least costly. Given the cost-cutting environment in which healthcare now operates worldwide, it is important that OPAT must develop its own procedures and guidelines for quality assurance. For OPAT to work away from the controlled environment of the hospital, it is essential that physicians, nurses and pharmacists adapt to new medical environments and work with the patient to ensure that care is maintained to a high standard.