Good practice recommendations for paediatric outpatient parenteral antibiotic therapy (p-OPAT) in the UK: a consensus
Sanjay Patel1, Ed Abrahamson2, Stephen Goldring3
1Department of Paediatric Infectious Diseases & Immunology, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK sanjay.patel@uhs.nhs.uk.
Insights
Managing children with intravenous antimicrobial therapy at home through paediatric outpatient parenteral antibiotic therapy (p-OPAT) services improves patient satisfaction and reduces healthcare-associated infections. These guidelines offer best practices for safe and effective p-OPAT delivery.
Area of Science:
- Pediatrics
- Infectious Diseases
- Health Services Research
Background:
- Home-based intravenous antimicrobial therapy for children offers benefits like improved patient satisfaction, psychological well-being, and reduced healthcare costs.
- Paediatric outpatient parenteral antibiotic therapy (p-OPAT) services are increasingly recognized for their potential to enhance care delivery.
Purpose of the Study:
- To develop good practice recommendations for paediatric outpatient parenteral antibiotic therapy (p-OPAT) services in the UK.
- To provide a practical framework for the safe and effective implementation of p-OPAT in secondary and tertiary care settings.
Main Methods:
- Joint development of guidelines by the BSAC and the British Paediatric Allergy, Immunity and Infection Group.
- Comprehensive review of clinical practice, governance, patient selection, vascular access, antimicrobial management, and business case development for p-OPAT.
Main Results:
- Established recommendations cover team roles, service structure, patient/pathology suitability, vascular access, antimicrobial choice, and clinical governance.
- Guidance includes a process for developing a business case to support p-OPAT service implementation.
Conclusions:
- Implementing robust p-OPAT services is crucial for optimizing paediatric antimicrobial therapy delivery.
- These recommendations aim to ensure high standards of clinical practice and governance in UK p-OPAT services.
Abstract:
There is compelling evidence to support the rationale for managing children on intravenous antimicrobial therapy at home whenever possible, including parent and patient satisfaction, psychological well-being, return to school/employment, reductions in healthcare-associated infection and cost savings. As a joint collaboration between the BSAC and the British Paediatric Allergy, Immunity and Infection Group, we have developed good practice recommendations to highlight good clinical practice and governance within paediatric outpatient parenteral antibiotic therapy (p-OPAT) services across the UK. These guidelines provide a practical approach for safely delivering a p-OPAT service in both secondary care and tertiary care settings, in terms of the roles and responsibilities of members of the p-OPAT team, the structure required to deliver the service, identifying patients and pathologies that are suitable for p-OPAT, ensuring appropriate vascular access, antimicrobial choice and delivery and the clinical governance aspects of delivering a p-OPAT service. The process of writing a business case to support the introduction of a p-OPAT service is also addressed.
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