Ambulatory antimicrobial use: the value of an outcomes registry

The opportunity for treating many serious infections in the community or ambulatory setting is growing. Outpatient parenteral antimicrobial therapy (OPAT) provides many potential advantages to the patient, hospital and clinician, including quality of life, cost savings and reduced risk of hospital-acquired infections due to antibiotic-resistant organisms. However, despite the evolution of this type of care in many countries, there have been continued questions and concerns about its safety and effectiveness. As with many new forms of therapy in medicine, the value of OPAT is in doubt because of the lack of published information concerning outcomes and its impact on patient care. In order to examine the quality of such programmes, an outcome-based registry of patients has been developed for OPAT. The core outcomes measures include clinical effectiveness, eradication of bacteria and adverse antibiotic events. The registry may also be adapted for benchmarking for quality assurance, surveying performance of new antimicrobials, cost effectiveness studies and comparisons of different antibiotics and their side effects.