[Outpatient parenteral antimicrobial therapy: challenges and opportunities]

Outpatient parenteral antimicrobial therapy (OPAT) enables the intravenous administration of anti-infective agents outside the hospital, within the patient's home environment, and can thereby shorten or even avoid inpatient stays. Internationally, OPAT has been well established for years, whereas its implementation in Germany has remained limited. The K‑APAT study demonstrated feasibility, efficacy, safety, and acceptance of this treatment model in Germany as well, showing a significant reduction in hospital days. Since 2024, an S1 guideline has, for the first time, provided a structured recommendation for performing OPAT. The approach is considered for infections without suitable oral treatment options and requires careful selection of appropriate patients. Key success factors include adherence to antimicrobial stewardship principles, guideline-based drug selection, adequate catheter management, and structured monitoring. Despite low complication rates, insufficient reimbursement structures and the lack of nationwide networks currently pose major barriers to broader implementation in Germany. Given current challenges-particularly the increasing number of complex infectious diseases alongside the ongoing shift to outpatient care, as well as persistent staff shortages and limited healthcare resources-OPAT represents a forward-looking, patient-centered model of care. The further development of standardized structures combined with health economic analyses within the German healthcare system forms the essential basis for sustainable implementation.