Practical considerations in the use of outpatient antimicrobial therapy for musculoskeletal infections.
Successful treatment of many musculoskeletal infections often requires an extended course of outpatient antimicrobial therapy, much of which is administered parenterally outside the hospital under the guidance of an infectious disease specialist. Delivery of outpatient parenteral antimicrobial therapy (OPAT) may occur in physicians' offices, ambulatory infusion centers, or hospital clinics but most frequently is done in patients' homes, often by the patients themselves. In this article, we outline the essential elements of outpatient antimicrobial therapy for musculoskeletal infections with particular emphasis on OPAT, including patient selection and evaluation; antimicrobial administration, including the route, duration, and complications of central venous access; and clinical and laboratory monitoring of antimicrobial therapy. We believe that primary care physicians, orthopedists, and infectious disease specialists caring for patients with musculoskeletal infections should become familiar with the use of, indications for, and complications of OPAT.
Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC 29425, USA. marcule@musc.edu
Camelia E
CE
Marculescu
Elie F
EF
Berbari
J Robert
JR
Cantey
Douglas R
DR
Osmon
D000553:Ambulatory Care / Q000379:methods; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D009140:Musculoskeletal Diseases / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents