Outpatient Parenteral Antimicrobial Therapy (OPAT): a review of experience at Auckland Hospital.
OBJECTIVE
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.
Upton
Arlo
A
Department of Clinical Microbiology, Auckland City Hospital, Auckland, New Zealand. Arlou@adhb.govt.nz
Ellis-Pegler
Rod B
RB
Woodhouse
Andrew
A
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001170:Arthritis, Infectious / Q000188:drug therapy; D005260:Female; D018718:Home Infusion Therapy / Q000009:adverse effects; D006801:Humans; D007239:Infections / Q000188:drug therapy*; D007262:Infusions, Intravenous; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy; D016459:Prosthesis-Related Infections / Q000188:drug therapy; D012646:Self Administration; D018461:Soft Tissue Infections / Q000188:drug therapy
D000900:Anti-Bacterial Agents