Outpatient Parenteral Antimicrobial Therapy (OPAT): a review of experience at Auckland Hospital

Arlo Upton, Rod B Ellis-Pegler, Andrew Woodhouse
New Zealand Medical Journal 2004 August 20, 117 (1200): U1020

AIM: To review the Auckland Hospital Outpatient Parenteral Antimicrobial Therapy (OPAT) Service.

METHODS: Patients (>15 years of age) were referred to the Service and assessed for suitability for outpatient therapy by an infectious diseases physician and a specialist nurse. Patient demographics, referring service, site of infection, and infecting organism, antimicrobial agent/s and outcomes of treatment including complications were recorded.

RESULTS: Over a 20-month period 100 patients were treated with 107 courses of outpatient parenteral antibiotic therapy. Bone and joint infections accounted for close to two thirds (60%) of the referrals; discitis/osteomyelitis (36%), septic arthritis (14%) and infected metalware/prosthetic joint infections (10%). Staphylococcus aureus was the most frequently isolated organism (42%), and in 21% of cases no organism was identified. In general, antibiotics prescribed were narrow spectrum and all but six patients self-administered up to four times daily. Eighty-eight percent of treatment courses resulted in a cure. Complications related to therapy occurred in 35% of patients.

CONCLUSIONS: We have found that parenteral antibiotic therapy can be administered safely and successfully in an outpatient setting despite relatively frequent dosing intervals. The majority of complications were minor, and 88% of patients were cured.

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