Outpatient parenteral antibiotic therapy: evolution of the Calgary adult home parenteral therapy program

In the past 25 years, outpatient antibiotic therapy has been recognized as a cost-effective, safe and patient-accepted means of managing patients with chronic infections who require prolonged parenteral therapy but otherwise do not need admission to hospital. We describe the home parenteral therapy program in Calgary, which reflects the next generation of outpatient antibiotic therapy in Canada because of its unique inclusion of patients with acute infections. The Calgary home parenteral therapy program has evolved from a few, small, single-site programs to a multisite, region-wide program that each year treats thousands of patients who require long- and short-term parenteral therapy. With escalating health care budgets and increased demand on acute-care hospital beds, existing programs in other centres may benefit from the Calgary experience, and this home parenteral therapy model may serve as a template for developing new outpatient antibiotic therapy programs in other regions.