Palliative outpatient parenteral antimicrobial therapy (OPAT): A single center experience and systematic scoping review

Abstract

Traditionally, outpatient parenteral antimicrobial therapy (OPAT) is used to treat infections with predictable course and anticipated response to therapy. However, there has been little consideration of OPAT for palliation as opposed to cure. This study presents a scoping review of literature and the experience of palliative OPAT at a tertiary referral hospital in Derbyshire, UK. Over the 5.5-year study period, six patients received OPAT for palliation (mean age 61 years). They accounted for 0.6 % (6/1044) and 3.1 % (1135/36658) of the total numbers of OPAT patients and bed-days saved, respectively. The literature search yielded 2375 articles, of which 5 case studies were eligible for review. Palliative OPAT provided positive experiences and outcomes for patients and their families. However, delivering palliative OPAT could be complex, time-consuming, and associated with clinical complications. There is a need for more research to address significant gaps in knowledge, especially regarding patient experiences and perspectives.

Keywords

• Antimicrobial stewardship
• Lifelong antimicrobial therapy
• Outpatient parenteral antimicrobial therapy
• Palliative care
• Palliative OPAT