History and evaluation of outpatient antimicrobial parenteral antibiotic therapy

In healthcare, there has been a growing emphasis on establishing quality care at a low price. To achieve this, the industry trend is to deliver care in the outpatient setting. A therapy that has been used in this setting since the 1970’s is Outpatient Parenteral Antibiotic Therapy (OPAT), which is a therapeutic practice to deliver intravenous or prolonged antimicrobial therapy in the outpatient or home setting. With the rise in utilization of this therapy two recommended guidelines have been published, Good Practice Recommendations for Outpatient Parenteral Antimicrobial Therapy (OPAT) in Adults in the UK and Practice Guidelines for Outpatient Parenteral Antimicrobial Therapy Today (IDSA). Literature regarding the obstacles and successes of OPAT has been published nationally and internationally, but have lacked breadth and consistency. This paper looks to identify the consistent and inconsistent trends in literature allowing for the identification of best practices that should be incorporated into OPAT programs. Furthermore, it evaluates the success of OPAT in the University of Pittsburgh Medical Center (UPMC) system, noted by the reduction in readmissions and improvement in cost effectiveness. The study of OPAT is relevant to public health, as it gives an alternative to inpatient care that could provide quality care with higher patient satisfaction. The literature, as well as the study at UPMC, supports OPAT as an effective and alternative therapy to inpatient care