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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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A National Survey of Outpatient Parenteral Antibiotic Therapy Practices

Louise E Vaz1, Kimberly K Felder1, Jason G Newland2

  • 1Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.

Journal of the Pediatric Infectious Diseases Society
|December 23, 2021
PubMed

Insights

Most pediatric infectious diseases (ID) clinicians do not require ID consultation for all outpatient parenteral antibiotic therapy (OPAT) cases. Enhanced ID involvement in post-discharge care is needed for serious infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Healthcare Management

Background:

  • Outpatient parenteral antibiotic therapy (OPAT) is increasingly common for serious pediatric infections.
  • Effective post-discharge follow-up is crucial for optimizing OPAT outcomes and preventing complications.
  • The role of infectious diseases (ID) specialists in managing OPAT and post-discharge care requires further investigation.

Purpose of the Study:

  • To assess current practices of pediatric infectious diseases (ID) clinicians regarding outpatient parenteral antibiotic therapy (OPAT).
  • To evaluate the extent of ID consultation and post-discharge follow-up for pediatric OPAT patients.
  • To identify opportunities for improving ID involvement in the management of serious infections treated with OPAT.

Main Methods:

  • A national survey was distributed to pediatric infectious diseases (ID) clinicians.
  • The survey collected data on OPAT practices, including consultation requirements and post-discharge care protocols.
  • Data analysis focused on current ID involvement and resource allocation for post-discharge care.

Main Results:

  • Only 15% of surveyed sites mandated infectious diseases (ID) consultation for all outpatient parenteral antibiotic therapy (OPAT) cases.
  • Significant variability was observed in the availability of ID division resources dedicated to post-discharge care.
  • Many sites reported limited ID clinician involvement in the ongoing management of patients on OPAT.

Conclusions:

  • Current infectious diseases (ID) consultation rates for pediatric outpatient parenteral antibiotic therapy (OPAT) are suboptimal.
  • There are significant opportunities to enhance the role of ID specialists in the post-discharge management of serious infections.
  • Strengthening ID involvement in OPAT care pathways can improve patient outcomes and antimicrobial stewardship.

Keywords:
OPATantimicrobial stewardshipoutpatient ID

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