Implementation of outpatient parenteral antimicrobial therapy program in the contemporary health care system: A narrative review of the evidence

Abstract

Outpatient parenteral antimicrobial therapy (OPAT) program has become an established clinical practice globally, though its implementation varies across jurisdictions. This review explores the implementation of OPAT within contemporary healthcare systems. OPAT services are organised centrally or decentrally within healthcare systems or integrated into hospital-at-home programs. Usually, a multidisciplinary team implements OPAT programs for carefully selected suitable patients. The implementation of OPAT is expanding into higher-risk patient populations, such as those with substance use-related infections and superadded infections in terminal illnesses. Additionally, OPAT has evolved to support transitioning from parenteral to oral therapy, with appropriate follow-up and monitoring. However, several barriers hinder the accessibility of the service. Enhancing communication between patients and healthcare providers, expanding training, integrating telemedicine, and strengthening outcome registries are crucial to improving the accessibility and effectiveness of OPAT services.

Keywords: Antimicrobial therapy; Implementation; OPAT; Outpatient.