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JAC Advance Access originally published online on June 11, 2007
Journal of Antimicrobial Chemotherapy 2007 60(2):356-362; doi:10.1093/jac/dkm210
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Outpatient parenteral antimicrobial therapy (OPAT): is it safe for selected patients to self-administer at home? A retrospective analysis of a large cohort over 13 years

Philippa C. Matthews1,2,*, Christopher P. Conlon1, Anthony R. Berendt1,2, Jill Kayley3, Lorrayne Jefferies4, Bridget L. Atkins1,2 and Ivor Byren1,2

1 Oxford Radcliffe Hospitals NHS Trust, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK 2 Bone Infection Unit, Nuffield Orthopaedic Centre NHS Trust, Windmill Road, Headington, Oxford OX3 7LD, UK 3 The Pavilion, Thames Road, Goring on Thames, Reading, Berkshire RG8 9AH, UK 4 Oxfordshire Primary Care Trust, Unit 1, Isis Business Park, Pony Road, Oxford OX4 2RD, UK

Received 19 February 2007; returned 10 April 2007; revised 16 May 2007; accepted 17 May 2007

* Corresponding author. Tel: +44-1865-738029; Fax: +44-1865-227694; E-mail: p.matthews{at}doctors.org.uk

Objectives: Provision of outpatient parenteral antimicrobial therapy (OPAT) is an evolving field, facilitating discharge from hospital for selected patients with serious infections. We report on a large OPAT cohort focusing on the practice of supervised parenteral antibiotic administration in the community by patients and relatives, which we collectively term ‘self-administration’. To distinguish between healthcare professional OPAT and self-administered OPAT, we have coined the terms H-OPAT and S-OPAT, respectively.

Patients and methods: We analysed data on 2059 OPAT episodes collected prospectively over a 13 year time period from 1993 to 2005.

Results: Clinical diagnosis, microbiology and antibiotics in this OPAT series are comparable to those previously reported. We identified no excess complications or hospital re-admissions in the S-OPAT group compared with the H-OPAT group.

Conclusions: Self-administration of intravenous antimicrobial therapy, in selected patients under the supervision of a specialist team, is a safe and feasible strategy.

Keywords: home intravenous therapy , H-OPAT , S-OPAT , self-administration , complications


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