Outpatient parenteral antimicrobial therapy in pediatrics: an opportunity to expand antimicrobial stewardship

Area of Science:

• Pediatric Infectious Diseases
• Antimicrobial Stewardship
• Healthcare Quality Improvement

Background:

• Outpatient parenteral antimicrobial therapy (OPAT) is common in pediatric care.
• Assessing the appropriateness of OPAT is crucial for optimizing patient outcomes and resource utilization.
• Previous studies have indicated variability in OPAT appropriateness across different healthcare settings.

Purpose of the Study:

• To evaluate the necessity and modifiability of OPAT in pediatric patient discharges.
• To identify opportunities for improving antimicrobial prescribing and management in the outpatient setting.
• To quantify the proportion of OPAT episodes that were potentially unnecessary or could be modified.

Main Methods:

• Retrospective review of patient discharge data.
• Analysis of all pediatric cases receiving OPAT.
• Assessment of treatment recommendations by a multidisciplinary team.

Main Results:

• A significant majority of OPAT episodes (78%) were identified as potentially modifiable.
• Over 40% of OPAT cases were deemed potentially unnecessary.
• Recommendations for modification or discontinuation were frequent across reviewed cases.

Conclusions:

• There are substantial opportunities to optimize the use of OPAT in pediatric populations.
• Implementing targeted interventions can improve the appropriateness of pediatric OPAT.
• Enhanced antimicrobial stewardship programs are essential for reducing unnecessary OPAT.