Appropriateness and Safety of Outpatient Parenteral Antimicrobial Therapy in Children

Outpatient parenteral antimicrobial therapy (OPAT) has long been considered to be a safe and effective method of treatment that provides an alternative to prolonged hospitalizations and improves quality of life. While utilization and outcomes of OPAT in adult patients have been well described, characteristics of pediatric OPAT are less well-known because of fewer studies. Madigan and Banerjee recently described characteristics and outcomes from a single center and reported 2.5% of their hospitalizations led to OPAT. In addition, approximately one third of OPAT led to catheteror antibioticassociated complications. Other studies have reported similar rates of complications associated with OPAT in children. Antimicrobial stewardship with infectious diseases consultations on OPAT have been shown to be effective in optimizing antimicrobial therapies and improving outcomes in adults. We conducted a review of OPATs at Children’s National Medical Center (CNMC) to identify targets for stewardship interventions and help develop strategies to optimize therapies. In addition, we examined the role of infectious diseases consultations and involvement in pediatric OPAT and the appropriateness of antimicrobial selection and dosing.

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