Current Status of Outpatient Parenteral Antimicrobial Therapy (OPAT) At a University-Affiliated Acute-Care Hospital in The Republic of Korea

Objectives The aim of this study was to describe current status of outpatient parenteral antimicrobial therapy (OPAT) at a tertiary care hospital in the Republic of Korea. Methods This retrospective study was conducted on outpatients and referral patients who had a prescription of parenteral antibiotics from July to December 2019. We reviewed the prescribed antimicrobials, the indication of antimicrobial therapy, where patients administered antimicrobial injection and management of pre- and post- prescriptions. Results Of the 577 episodes included in this study, 399 (69.2%) were delivered by referral model, 178 (30.8%) by outpatient model. About 70% of OPATs were prescribed in the pulmonology, infectious diseases, orthopedics, gastroenterology, and hematology departments. Five antibiotics (ertapenem (26.0%), ceftriaxone (12.8%), kanamycin (11.8%), amikacin (10.1%), and cefazolin (8.5%)) accounted for 69.2% of the total OPATs. Urinary tract infections (27.3%), respiratory infections (20.8%), and intra-abdominal infections (15.9%) are the most frequent indications of OPAT. After prescription, there were 295 (73.9%) follow-up visits in referral model and 150 (84.3%) in outpatient model (p<0.05). Laboratory tests necessary for monitoring were totally performed in 274 (47.5%). Conclusions We found that significant number of OPAT was prescribed, follow-up visits were not performed in about a quarter of episodes, and laboratory monitoring was not fully conducted in more than half of the cases. Therefore, it is necessary to establish an appropriate management program for OPAT. Considering limited resources and the distribution of OPAT prescriptions, it may be effective to select frequently used antibiotics or frequently prescribed departments and start the program for them.