Delivery of Outpatient Parenteral Antimicrobial Therapy (OPAT) in an Ever-Changing National Health Service (UK): Benefits, Barriers, and Opportunities

Abstract

Outpatient parenteral antimicrobial therapy (OPAT) is increasingly used to manage a broad range of infections, enabling patients to receive intravenous antibiotics safely outside inpatient settings. In this review, we examine the current landscape of OPAT practice across the United Kingdom (UK), assessing its clinical, economic, and operational impact. The benefits of OPAT for patients and the National Health Service (NHS), as well as its associated risks, are discussed. Additionally, we explore the challenges hindering its broader implementation within the UK. Finally, we highlight recent innovations and emerging applications of OPAT relevant to the NHS, underscoring key considerations for its future expansion and emphasising the need for a nationally coordinated strategy to realise its full potential.

Keywords: National Health Service; OPAT; UK; benefits; outpatient parenteral antimicrobial therapy; risks.

Figure 1

OPAT within the virtual wards concept. Proposed Pathways: A—Patients requiring only parenteral or complex oral antimicrobial therapy. B—Patients needing both acute care and parenteral or complex oral antimicrobial therapy. C—Patients suitable for acute clinical care outside the hospital setting, without requiring parenteral antimicrobial therapy. RM (Remote Monitoring)—collaborative care between the OPAT team and the virtual ward team. Patients may transition to either exclusive OPAT or virtual ward care upon completion of the required treatment (represented by the blue broken arrow).