title: Outpatient parenteral antimicrobial therapy practices among adult infectious disease physicians.
abstract: OBJECTIVE
  To identify current outpatient parenteral antibiotic therapy practice patterns and complications.
  
  
  METHODS
  We administered an 11-question survey to adult infectious disease physicians participating in the Emerging Infections Network (EIN), a Centers for Disease Control and Prevention-sponsored sentinel event surveillance network in North America. The survey was distributed electronically or via facsimile in November and December 2012. Respondent demographic characteristics were obtained from EIN enrollment data.
  
  
  RESULTS
  Overall, 555 (44.6%) of EIN members responded to the survey, with 450 (81%) indicating that they treated 1 or more patients with outpatient parenteral antimicrobial therapy (OPAT) during an average month. Infectious diseases consultation was reported to be required for a patient to be discharged with OPAT by 99 respondents (22%). Inpatient (282 [63%] of 449) and outpatient (232 [52%] of 449) infectious diseases physicians were frequently identified as being responsible for monitoring laboratory results. Only 26% (118 of 448) had dedicated OPAT teams at their clinical site. Few infectious diseases physicians have systems to track errors, adverse events, or "near misses" associated with OPAT (97 [22%] of 449). OPAT-associated complications were perceived to be rare. Among respondents, 80% reported line occlusion or clotting as the most common complication (occurring in 6% of patients or more), followed by nephrotoxicity and rash (each reported by 61%). Weekly laboratory monitoring of patients who received vancomycin was reported by 77% of respondents (343 of 445), whereas 19% of respondents (84 of 445) reported twice weekly laboratory monitoring for these patients.
  
  
  CONCLUSIONS
  Although use of OPAT is common, there is significant variation in practice patterns. More uniform OPAT practices may enhance patient safety.
authors.affiliation: Department of Internal Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Lane
authors.forename: Jonas
authors.initials: J
authors.lastname: Marschall
authors.forename: Susan E
authors.initials: SE
authors.lastname: Beekmann
authors.forename: Philip M
authors.initials: PM
authors.lastname: Polgreen
authors.forename: Ritu
authors.initials: R
authors.lastname: Banerjee
authors.forename: Adam L
authors.initials: AL
authors.lastname: Hersh
authors.forename: Hilary M
authors.initials: HM
authors.lastname: Babcock
mesh_terms: D000553:Ambulatory Care; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D003428:Cross Infection / Q000517:prevention & control*; D019538:Health Care Surveys; D006801:Humans; D017053:Infection Control / Q000379:methods*; D016357:Infection Control Practitioners; D009656:North America
chemical_list: D000890:Anti-Infective Agents