Experience of infectious diseases consultants with outpatient parenteral antimicrobial therapy: results of an emerging infections network survey.
BACKGROUND
Despite the increasing use of outpatient parenteral antimicrobial therapy (OPAT), little is known about the role of infectious diseases consultants in the process or their perceptions of OPAT.


METHODS
In May 2004, the Infectious Diseases Society of America Emerging Infections Network (EIN) surveyed its members to characterize their involvement and experiences with OPAT.


RESULTS
Of the 454 respondents (54%) who completed the questionnaire, 426 (94%) indicated that patients in their primary inpatient facility were "frequently" discharged while receiving OPAT, estimating that, on average, 19 patients are discharged from their hospitals while receiving OPAT each month. Although 86% of EIN members stated that they personally order OPAT for some patients, 18% indicated that they have no involvement, and 37% stated they only rarely or occasionally oversee OPAT. EIN members involved in OPAT estimated that approximately 90% of their patients who take OPAT received therapy at home, and the members described variable monitoring and oversight methods. Of the respondents, 68% of providers collectively estimated that they encountered 1951 infectious and serious noninfectious complications of OPAT in the past year. The most frequently used antibiotics included vancomycin, ceftriaxone, and cefazolin, most commonly used for bone and joint infections.


CONCLUSIONS
These results testify to the pervasive use of OPAT in today's health care system, the variable role of infectious diseases consultants, and the heterogeneity in oversight and management practices. The widespread use of OPAT and its frequent complications indicate the need for additional studies to establish optimal methods of delivery and management to insure the quality and safety of the process.
Chary
Aarthi
A
Division of Infectious Diseases, Oregon Health & Sciences University, Portland, OR 97207, USA.
Tice
Alan D
AD
Martinelli
Lawrence P
LP
Liedtke
Laura A
LA
Plantenga
Melissa S
MS
Strausbaugh
Larry J
LJ
D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003141:Communicable Diseases / Q000150:complications / Q000188:drug therapy*; D003253:Consultants; D004864:Equipment and Supplies / Q000009:adverse effects; D019538:Health Care Surveys; D006699:Home Care Services; D006801:Humans; D007255:Information Services; D007263:Infusions, Parenteral / Q000009:adverse effects* / Q000379:methods; D010045:Outpatients
D000890:Anti-Infective Agents