Outpatient parenteral antibiotic therapy

Outpatient parenteral antibiotic therapy (OPAT) is used to administer non-oral antibiotics (usually intravenously) without the need for ongoing hospitalisation. OPAT is particularly useful for people who are not severely ill but do require a prolonged course of treatment that cannot be given in oral form.^[1] OPAT is being increasingly adopted as part of antimicrobial stewardship programs; it can reduce length of stay, costs and adverse events while improving quality of life.^[2] OPAT can be administered in an outpatient facility (including a provider's office, infusion center or day hospital) or at a patient's residence using an infusion pump, such as an elastomeric pump.^[3][4]

Outpatient parenteral antibiotic therapy
Other names	OPAT

Common antimicrobials

Common antimicrobials used for continuous infusion are shown below:^[5]

Antibiotic	Stability at 25 °C	Diluent	Existing data in elastomeric pumps
cefepime	24 hours	normal saline	Yes
ceftazidime	48 hours	normal saline	Yes
clindamycin	16 days	dextrose 5%	No
flucloxacillin	24 hours	normal saline	Yes
fosfomycin	24 hours	water for injection	No
oxacillin	24 hours	normal saline	No
benzylpenicillin potassium	24–48 hours	ringer acetate	Yes
benzylpenicillin sodium	12–24 hours	normal saline	Yes
piperacillin/tazobactam	24 hours	normal saline	Yes
vancomycin	7 days	normal saline	Yes

Before starting beta-lactams and vancomycin infusion, it is advisable to administer a loading dose in order to reduce time to reach target concentrations^[6][7]