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International Journal of Clinical Pharmacy

, Volume 34, Issue 3, pp 410–417 | Cite as

Outpatient parenteral antimicrobial therapy with ceftriaxone, a review

  • Christopher J. A. DuncanEmail author
  • David A. Barr
  • R. Andrew Seaton
Review Article

Abstract

Background More than 30 years since it was developed for clinical use, the third-generation cephalosporin ceftriaxone remains the most commonly used agent for outpatient parental antimicrobial therapy (OPAT). Recent antimicrobial stewardship programmes have tended to restrict ceftriaxone use in hospitals to control antibiotic resistance and outbreaks of Clostridium difficle infection (CDI). Considering the expansion of OPAT programmes both in the UK and worldwide, revisiting the role of ceftriaxone in OPAT in the context of changing antimicrobial prescribing practices is timely. Aim of the review To identify the evidence base for OPAT, review current and historical data on indications for, and safety of ceftriaxone within the OPAT setting, and to provide some perspectives on the future role of ceftriaxone. Method We searched PubMed and Scopus for articles published in English, and hand searched reference lists. We also conducted a complementary descriptive analysis of prospectively acquired data on the use of ceftriaxone in more than 1,300 OPAT episodes over a 10-year period in our UK centre. Results Ceftriaxone has an excellent safety profile in the OPAT setting, and its broad spectrum of activity makes it an established agent in a wide range of clinical infection syndromes, such as skin and soft-tissue infection, bone and joint infection, streptococcal endocarditis and several others. Intriguingly, in contrast to the inpatient setting, liberal use of ceftriaxone in OPAT has not been strongly linked to CDI, suggesting additional patient and environmental factors may be important in mediating CDI risk.

Keywords

Antimicrobial stewardship Cefalosporin Ceftriaxone Cephalosporin Clostridium difficle infection Indications OPAT Outpatient parenteral antimicrobial therapy Safety Third-generation cephalosporin 

Notes

Acknowledgments

CJAD is supported by a Wellcome Trust Research Training Fellowship.

Funding

None.

Conflicts of interest

RAS has previously received speaker fees, consultancy and research funding from Novartis and Pfizer.

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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Christopher J. A. Duncan
    • 1
    • 2
    Email author
  • David A. Barr
    • 1
  • R. Andrew Seaton
    • 1
  1. 1.Brownlee Centre for Infection, Tropical Medicine and CounsellingGartnaval HospitalGlasgowUK
  2. 2.Sir William Dunn School of PathologyUniversity of OxfordOxfordUK

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