Outpatient Parenteral Antimicrobial Therapy (OPAT): a review of experience at Auckland Hospital.

AIM: 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.