Recent innovations and new applications of outpatient parenteral antimicrobial therapy

被引:12
作者
Farmer, Eoghan Charles William [1 ]
Seaton, Ronald Andrew [1 ]
机构
[1] Queen Elizabeth Univ Hosp, Infect Dis Dept, Glasgow G51 4TF, Lanark, Scotland
关键词
OPAT; copat; palliative OPAT; antimicrobial stewardship; dalbavancin; flucloxacillin; meropenem; drug stability; people who inject drugs; ANTIBIOTIC-THERAPY; WEEKLY DALBAVANCIN; OPAT; MANAGEMENT; CATHETER; COMMUNITY; EFFICACY; IMPACT; SAFETY; IMPLEMENTATION;
D O I
10.1080/14787210.2020.1810566
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Introduction Outpatient parenteral antimicrobial therapy (OPAT) is safe and effective for selected patients managed within an organized clinical service. Service configurations however are evolving, patient populations are changing and new evidence is emerging which challenges traditional OPAT practice. Areas covered This review will discuss evolving OPAT service delivery from the traditional model of infusion center toward nonspecialist, community and remotely delivered OPAT and the challenges this represents. We consider new patient populations including those with incurable infection or infections at the end of life and difficult to reach populations including people who inject drugs. The evidence base that underpins the multi-disciplinary approach to OPAT delivery will be examined and particularly the role of the antimicrobial pharmacist and specialist nurse. Evidence for new treatment options which challenge established OPAT practice including complex oral antibiotic regimens, long acting parenteral agents and drug stability in continuous infusion antibiotics will be considered. Finally we emphasize the central importance of antimicrobial stewardship and good clinical governance which should underpin OPAT practice. Expert opinion Changing patient populations, service structures and team roles coupled with a growing infection management evidence base means that OPAT services and practice must evolve. Challenging traditional practice is essential to ensure best patient outcomes and cost-efficiency.
引用
收藏
页码:55 / 64
页数:10
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