title: A national survey of infectious disease practitioners on their use of outpatient parenteral antimicrobial therapy (OPAT).
abstract: BACKGROUND
  The use of outpatient parenteral antimicrobial therapy (OPAT) is standard medical practice; however, significant heterogeneity in practice exists. We hypothesized that formal OPAT programs are associated with increased physician participation in patient safety activities.
  
  
  METHODS
  United States Infectious Disease (ID) physicians were contacted and asked to participate in an electronic survey from April through June 2012. Data were analyzed using SPSS version 20.
  
  
  RESULTS
  In all, 3718 physicians were contacted and 316 (8.5%) responded. Respondents practice in 47 states; the majority (79%) practice adult ID, 11% pediatric ID, 10% a combination of the two. Sixty percent reported that ID consultation was not mandatory before OPAT, and 75% of these respondents thought it should be compulsory. The most common indications were osteomyelitis, prosthetic joint infections, and endocarditis, and the most common antibiotics were vancomycin, ceftriaxone, and ertapenem. Most respondents (59%) discharge patients with OPAT weekly, and have a median number of 11 OPAT patients (95% confidence interval (CI) 8.5-13.4). Half of respondents have a formal OPAT program. Fifty-two percent report no systematic method of communication between inpatient and outpatient physicians when patients are discharged with OPAT, 49% have no systematic method of lab tracking, and 34% have no method of ensuring patient adherence to clinic visits. All of these patient safety measures were more likely to be present in practice sites with formal OPAT programs (p < 0.001).
  
  
  CONCLUSIONS
  Opportunities exist for improving OPAT monitoring and patient safety. Formal OPAT programs provide the framework for safe and effective care and are to be encouraged.
authors.affiliation: From the Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center , Boston.
authors.forename: Eavan G
authors.initials: EG
authors.lastname: Muldoon
authors.forename: Karen
authors.initials: K
authors.lastname: Switkowski
authors.forename: Alan
authors.initials: A
authors.lastname: Tice
authors.forename: David R
authors.initials: DR
authors.lastname: Snydman
authors.forename: Geneve M
authors.initials: GM
authors.lastname: Allison
mesh_terms: D061605:Administration, Intravenous / Q000706:statistics & numerical data; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004696:Endocarditis / Q000188:drug therapy; D019538:Health Care Surveys; D006801:Humans; D010019:Osteomyelitis / Q000188:drug therapy; D016459:Prosthesis-Related Infections / Q000188:drug therapy; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents
keywords: OPAT; infectious diseases; outpatient parenteral antimicrobial therapy; patient safety; survey