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. 2025 May 27;7(3):dlaf075.
doi: 10.1093/jacamr/dlaf075. eCollection 2025 Jun.

Current practices in outpatient parenteral antimicrobial therapy programmes: an international multi-centre survey

Zenaw T Wolie  1   2 , Jason A Roberts  1   3   4   5 , Luis Eduardo López-Cortés  6   7   8 , Manuel Mirón-Rubio  9 , James Pollard  10 , Afra Nahdia Marizan Nor  11 , Mohd H Abdul-Aziz  1 , Conor Jamieson  12 , R Andrew Seaton  13   14 , Mark Gilchrist  14   15   16 , Fekade B Sime  1
Affiliations

Current practices in outpatient parenteral antimicrobial therapy programmes: an international multi-centre survey

Zenaw T Wolie et al. JAC Antimicrob Resist. .

Abstract

Objectives: This study aimed to assess the current international practices of outpatient parenteral antimicrobial therapy (OPAT).

Methods: A multi-site cross-sectional study was conducted, using REDCap platform for survey distribution and data collection. Data analysis was performed in SPSS version 29.

Results: Of the 146 OPAT responding centres serving adults, paediatrics or both, 82% have been operating for over 10 years. OPAT teams were multidisciplinary, with nurses comprising the largest proportion in 89% of centres, followed by infectious disease (ID) pharmacists (83%) and ID physicians (80%). Service activity varied widely, with 92% centres treating fewer than 100-5000 patients annually (median = 300). Home-based models of care were used by more than 85% of facilities in Australia, the UK and Spain, while 82% of Malaysian and 75% of UK centres used infusion centres. Common OPAT indications include skin and soft tissue, bone and joint, urinary tract and respiratory tract infections, with ceftriaxone and ertapenem used by over 80% of the centres. Peripherally inserted central and midline catheters were common except in Malaysia. Among enrolled centres, complex oral antimicrobial therapy supervision was higher in the UK (82%) than in Spain (77%), Australia (42%) and Malaysia (24%). Inconsistencies in guidelines supporting antimicrobial stability and dosing information were noted, with a call for more stability data on certain antimicrobials.

Conclusions: This study revealed significant variation in OPAT practice. Further study is needed to understand the reasons for these differences and whether better alignment of practice could improve patient outcomes, antimicrobial stewardship practice and resource utilization.

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Figures

Figure 1.
Figure 1.
OPAT models of care and the percentage of centres reporting the use of these models (other(s)# = listed out in Table S3).
Figure 2.
Figure 2.
Different types of VADs and the percentage of responding centres reporting the use of these devices.
Figure 3.
Figure 3.
Medication administration infusion pumps and the percentage of responding centres reporting the use of these devices.
Figure 4.
Figure 4.
The percentage of participant facilities reporting the inclusion/absence of antimicrobial dosing information in both national and local guidelines.
Figure 5.
Figure 5.
Percentage of OPAT delivery centres regarding bolus IV push or short infusion dosing of antimicrobials.
See this image and copyright information in PMC

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