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OPAT in Switzerland: single-center experience of a model to treat complicated infections

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Outpatient parenteral antimicrobial therapy (OPAT) programmes are established in the minority of Swiss hospitals. We aimed to study the OPAT programme at the University Hospital Basel during a 3-year period to evaluate safety and outcome.


All patients treated in the OPAT programme between 2015 and 2017 were included in the study. Demographic, clinical and OPAT outcome data were extracted from the hospital information system. Differences between treatment periods were analysed and risk factors for readmission and adverse events identified.


In total, 462 patients were enrolled from 2015 to 2017. Patient numbers and total treatment days increased by 68% and 116%, respectively. Indications included many complicated infections such as bone and joint (23%) and intravascular infections (13%). Of the identified Gram-negative bacteria, 25% produced extended spectrum beta-lactamases. The percentage of antibiotics administrated with an elastomeric device increased from 11% in 2015 to 29% in 2017, whereas the use of once-daily antimicrobials (such as ceftriaxone) declined. Adverse events were rare (n = 67; 14.6%) including only two severe catheter-related events. Cure was noted in 98% of patients. 30-day unplanned readmission occurred in 46 (10.0%) patients, and intravascular infections and a higher Charlson comorbidity index were identified as independent predictors.


This study demonstrates the successful implementation of a formal OPAT programme in a Swiss tertiary care hospital. Careful selection of patients and monitoring during treatment are crucial to avoid frequent readmissions. Hence, our data call for an expansion of OPAT services in Switzerland in the near future.

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  1. 1.

    Gilchrist M, Seaton RA. Outpatient parenteral antimicrobial therapy and antimicrobial stewardship: challenges and checklists. J Antimicrob Chemother. 2014;70:1–6.

  2. 2.

    Paladino JA, Poretz D. Outpatient parenteral antimicrobial therapy today. Clin Infect Dis. 2010;51:S198–208.

  3. 3.

    Gardiol C, Voumard R, Cochet C, Vallière S. Setting up an outpatient parenteral antimicrobial therapy (OPAT) unit in Switzerland: review of the first 18 months of activity. Eur J Clin Microbiol Infect Dis. 2016;35:1–7.

  4. 4.

    De Vallière S. Is there a place for Outpatient parenteral antibiotic therapy (OPAT) in Switzerland? Joint Meeting Club de pathologie infectieuse. Bern; 2018. pp 1–22. Accessed 10 July 2019.

  5. 5.

    Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.

  6. 6.

    Federal Office of Public Health. Swiss antibiotic resistance report. Switzerland: Federal Office of Public Health; 2018. p. 1–197.

  7. 7.

    Durojaiye OC, Bell H, Andrews D, Ntziora F, Cartwright K. Clinical efficacy, cost analysis and patient acceptability of outpatient parenteral antibiotic therapy (OPAT): a decade of Sheffield (UK) OPAT service. Int J Antimicrob Agents. 2018;51:26–32.

  8. 8.

    MacKenzie M, Rae N, Nathwani D. Outcomes from global adult outpatient parenteral antimicrobial therapy programmes: a review of the last decade. Int J Antimicrob Agents. 2014;43:7–16.

  9. 9.

    Palms DL, Jacob JT. Close patient follow-up among patients receiving outpatient parenteral antimicrobial therapy. Clin Infect Dis. 2019.

  10. 10.

    Federal Statistical Office. Statistical Data on Switzerland 2017. Federal Statistical Office. Section Dissemination and Publications. 2017; 2017. pp 1–52.

  11. 11.

    Huang V, Ruhe JJ, Lerner P, Fedorenko M. Risk factors for readmission in patients discharged with outpatient parenteral antimicrobial therapy: a retrospective cohort study. BMC Pharmacol Toxicol. 2018;19:1–9.

  12. 12.

    Means L, Bleasdale S, Sikka M, Gross AE. Predictors of hospital readmission in patients receiving outpatient parenteral antimicrobial therapy. Pharmacotherapy. 2016;36:934–9.

  13. 13.

    Bengoetxea I, Onaindia MMJ, Apezetxea MA, Gomez PM, Goyeneche MM, Fernandez MM, et al. Predictive clinical rule for readmissions in OPAT. Improving in security. Open Forum Infect Dis. 2017;4:1.

  14. 14.

    Chapman ALN, Seaton RA, Cooper MA, Hedderwick S, Goodall V, Reed C, et al. Good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults in the UK: a consensus statement. J Antimicrob Chemother. 2012;67:1053–62.

  15. 15.

    Barr DA. Outpatient parenteral antimicrobial therapy (OPAT) in a teaching hospital-based practice: a retrospective cohort study describing experience and evolution over 10 years. Int J Antimicrob Agents. 2012;39:407–13.

  16. 16.

    Lee B, Tam I, Weigel B IV, Breeze JL, Paulus JK, Nelson J, et al. Comparative outcomes of β-lactam antibiotics in outpatient parenteral antibiotic therapy: treatment success, readmissions and antibiotic switches. J Antimicrob Chemother. 2015;70:2389–96.

  17. 17.

    Wieland BW, Marcantoni JR, Bommarito KM, Warren DK, Marschall J. A retrospective comparison of ceftriaxone versus oxacillin for osteoarticular infections due to methicillin-susceptible Staphylococcus aureus. Clin Infect Dis. 2012;54:585–90.

  18. 18.

    Imani S, Buscher H, Marriott D, Gentili S, Sandaradura I. Too much of a good thing: a retrospective study of β-lactam concentration–toxicity relationships. J Antimicrob Chemother. 2017;72:2891–7.

  19. 19.

    Chapman ALN, Dixon S, Andrews D, Lillie PJ, Bazaz R, Patchett JD. Clinical efficacy and cost-effectiveness of outpatient parenteral antibiotic therapy (OPAT): a UK perspective. J Antimicrob Chemother. 2009;64:1316–24.

  20. 20.

    Underwood J, Marks M, Collins S, Logan S, Pollara G. Intravenous catheter-related adverse events exceed drug-related adverse events in outpatient parenteral antimicrobial therapy. J Antimicrob Chemother. 2018;74:787–90.

  21. 21.

    Safdar N, O’Horo JC, Ghufran A, Bearden A, Didier ME, Chateau D, et al. Chlorhexidine-impregnated dressing for prevention of catheter-related bloodstream infection. Crit Care Med. 2014;42:1703–13.

  22. 22.

    Theocharis G, Rafailidis PI, Rodis D, Kontopidis I, Barbas SG, Falagas ME. Outpatient parenteral antibiotic therapy (OPAT) at home in Attica, Greece. Eur J Clin Microbiol Infect Dis. 2012;31:2957–61.

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This work was supported by departmental funds of the Division of Internal Medicine, University Hospital Basel, Basel, Switzerland

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Correspondence to Michael Osthoff.

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Erba, A., Beuret, M., Daly, M. et al. OPAT in Switzerland: single-center experience of a model to treat complicated infections. Infection (2019).

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  • Outpatient parenteral antibiotic therapy
  • Switzerland
  • Outcome
  • Safety
  • Complicated infections