Editorial

Outpatient Parenteral Antibiotic Therapy: Not So Crazy After All These Years

Authors: Keith M. Ramsey, MD, John A. Vande Waa, DO, PhD

Abstract

Outpatient parenteral antibiotic therapy, or OPAT, has emerged as an essential component of our health care delivery system in the United States. The idea evolved from the initial use of an indwelling Silastic catheter for the successful delivery of home total parenteral nutrition for a patient with massive mesenteric thrombosis with no complication of infection after more than 23 months of use.1 Subsequently, pilot studies in Canada2 and in the US3 suggested an alternative to inpatient IV antibiotic delivery via the use of OPAT, using standard IV antibiotics. In the early 1980s, Dr. Donald Poretz and colleagues at Fairfax Hospital in Falls Church, VA, recognized the potential value of outpatient antimicrobial therapy for clinically stable patients with diseases such as bacterial endocarditis and osteomyelitis and were successful in convincing third party carriers in the greater Washington, DC area to provide payment for OPAT. Their initial open study documented both the efficacy and especially the safety of this novel approach.4

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References

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