Outpatient parenteral antimicrobial therapy (OPAT) programs for pediatric patients: A systematic review.

OBJECTIVE

The aim of this study is to guide other investigators in designing and implementing an appropriate pediatric outpatient parenteral antimicrobial therapy (OPAT) program in healthcare settings.

METHODS

A systematic review of studies that included a description of OPAT in children was conducted. A register of the review protocol was carried out in PROSPERO (registration number: CRD420251054490), which followed PRISMA guidelines. The literature search was performed in four healthcare databases (PubMed, EMBASE, Cochrane Library and CINAHL) with no publication date or language restrictions.

RESULTS

A total of 1764 articles were identified, of which only 37 met the inclusion criteria. Most OPAT programs were home-based and mainly involved pediatricians and nurses. In terms of clinical results, most programs demonstrated a hospital readmission rate of 0-10% and full antimicrobial therapy completion. In regard to safety, catheter-related infections and neutropenia were the most common complications identified.

CONCLUSION

Home-based therapy treatment appears to be the most frequently implemented model, associated with reduced healthcare costs and high patient and caregiver satisfaction. This systematic review advances current knowledge by synthesizing available evidence on pediatric OPAT program organization, clinical outcomes, and safety, and by identifying key gaps to inform future program development and standardization.