Related Experiment Video
Updated: Jun 10, 2025
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Short-term Outpatient Parenteral Antimicrobial Therapy Administration in the Pediatric Emergency Department:
Hashim M Bin Salleeh1, Syed Amir Ahmad1, Tahani Al Ahmadi2
1From the Departments of Emergency Medicine.
Insights
Pediatric Outpatient Parenteral Antimicrobial Therapy (OPAT) is safe and effective for children, reducing hospital admissions and improving resource use. This study evaluated its safety and outcomes in a pediatric emergency setting.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Diseases
- Pharmacology
Background:
- Outpatient Parenteral Antimicrobial Therapy (OPAT) offers a cost-effective alternative to inpatient care.
- Evidence supporting pediatric OPAT protocols, particularly in emergency settings, is limited.
- This study addresses the need for data on the safety and utilization of pediatric emergency-based OPAT.
Purpose of the Study:
- To describe the utilization patterns of pediatric emergency-based OPAT.
- To evaluate the safety and clinical outcomes of this therapeutic approach in children.
- To assess the impact of pediatric OPAT on hospital admission rates.
Main Methods:
- Prospective, observational study design.
- Inclusion of children under 14 years requiring emergency department-based OPAT.
- Data collection on treatment duration, antimicrobial agents, indications, complications, and outcomes.
Main Results:
- 392 children were included, with a mean OPAT duration of 3.5 days.
- Ceftriaxone was the most common antimicrobial; chest infections, sickle cell disease with fever, and soft tissue infections were primary indications.
- High success rate (89.5%) with minimal IV line complications; only 10.4% required hospital admission, primarily due to lack of improvement, without intensive care needs.
Conclusions:
- Pediatric emergency-based OPAT is a safe and effective practice for children.
- The approach demonstrates good clinical outcomes and contributes to efficient hospital resource utilization by reducing admissions.
- Further implementation of pediatric OPAT can be supported by these findings.
Objectives:
The practice of administration of intravenous (IV) antimicrobial therapy in outpatient settings (OPAT) is a low-cost alternative to in-patient admission and treatment. There is, however, limited evidence supporting OPAT management protocols for children. The primary objective of this study was to describe the use of pediatric emergency-based OPAT, as well as the safety of this practice.
Methods:
The study was a prospective, observational study conducted in pediatric emergency department of a tertiary care hospital. Children younger than 14 years who required pediatric emergency department-based OPAT were included in the study.
Results:
Three hundred and ninety-two children were included in the study. The mean duration of OPAT was 3.5 days. Ceftriaxone was the most frequently used antimicrobial. Chest infection was the commonest indication, followed by sickle cell disease with fever and soft tissue infections. There were no major intravenous line-related complications over course of treatment. Most of the patients (89.5%) completed the OPAT course successfully. Only 10.4% patients required subsequent hospital admission, with failure to improve on the OPAT protocol being the main reason patients for admission. None of the admitted patients required intensive care settings or faced unexpected morbidity.
Conclusions:
Our results affirm that pediatric emergency-based OPAT is a safe yet effective practice in children with good clinical outcome. We believe that a reduction in admissions translates to better hospital resource utilization.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:25Routes of Drug Administration: Parenteral
The intravenous route (IV) of drug administration can be further categorized into two types. The bolus injection administers the entire dose rapidly, while an intravenous infusion slowly delivers smaller doses steadily.
The IV route is often...
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:28Antimicrobial Effectiveness