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Evaluation of OPAT in the Age of Antimicrobial Stewardship

  • Antimicrobial Stewardship (M Stevens, Section Editor)
  • Published:
Current Treatment Options in Infectious Diseases Aims and scope Submit manuscript

Abstract

Purpose of review

Antimicrobial stewardship and outpatient parenteral antimicrobial therapy (OPAT) collide with the newest Joint Commission requirements for outpatient antimicrobial stewardship. The purpose of this paper was to present key stewardship areas applicable to OPAT and review the data behind them.

Recent findings

Data on these topics is emerging. Long treatment durations are being challenged and oral routes are garnering evidence for treatment of traditionally intravenous-only regimens. Stability information and incorporation of pharmacokinetic and pharmacodynamic properties may lead to use of continuous infusions, once daily dosing, or long-acting lipoglycopeptides. Different models for patient follow-up, frequency of monitoring, and adverse effect profiles can be used. As the popularity and necessity of OPAT and stewardship programs increase, there is opportunity for multidisciplinary collaboration.

Summary

While there are many overlapping stewardship principles in OPAT, there may be appropriately discordant principles in this unique scenario as well.

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Authors and Affiliations

  1. Specialty Pharmacy, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Monica V. Mahoney PharmD, BCPS AQ-ID, BCIDP

  2. Inpatient Pharmacy Department, University of New Mexico Hospital, Albuquerque, NM, USA

    Keenan L. Ryan PharmD, PhC

  3. Department of Pharmaceutical and Nutrition Care, Nebraska Medicine, Omaha, NE, USA

    Bryan T. Alexander PharmD, BCPS, BCIDP, AAHIVP

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  1. Monica V. Mahoney PharmD, BCPS AQ-ID, BCIDP
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Correspondence to Monica V. Mahoney PharmD, BCPS AQ-ID, BCIDP.

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Dr. Mahoney reports personal fees from Cepheid, personal fees from Tetraphase, personal fees from Spero, personal fees from Qpex, grants from Merck, outside the submitted work. Dr. Ryan reports personal fees from Theravance, outside the submitted work. Dr. Alexander reports personal fees from Astellas Pharma, outside the submitted work.

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Mahoney, M.V., Ryan, K.L. & Alexander, B.T. Evaluation of OPAT in the Age of Antimicrobial Stewardship. Curr Treat Options Infect Dis 12, 158–177 (2020). https://doi.org/10.1007/s40506-020-00217-6

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