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Outpatient parenteral antimicrobial therapy (OPAT) programs for pediatric patients: A systematic review

Pablo Ciudad-Gutiérrez1, Paloma Suárez-Casillas1, Laura Herrera-Hidalgo1

  • 1Department of Pharmacy, Virgen del Rocio University Hospital, Seville, Spain; Institute of Biomedicine of Seville, Virgen del Rocio University Hospital/CSIC/University of Seville, Seville, Spain.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|March 21, 2026
PubMed

Insights

This systematic review guides the design of pediatric outpatient parenteral antimicrobial therapy (OPAT) programs. Home-based OPAT shows promise for cost reduction and patient satisfaction, with manageable safety concerns.

Area of Science:

  • Pediatric Infectious Diseases
  • Healthcare Program Design
  • Systematic Review Methodology

Background:

  • Pediatric outpatient parenteral antimicrobial therapy (OPAT) programs require careful design and implementation.
  • Standardized approaches are needed to optimize care delivery for children receiving intravenous antibiotics at home or in outpatient settings.

Purpose of the Study:

  • To provide guidance for healthcare professionals designing and implementing pediatric OPAT programs.
  • To synthesize current evidence on the organization, clinical outcomes, and safety of pediatric OPAT.

Main Methods:

  • A systematic review of studies describing pediatric OPAT programs was conducted.
  • Searches were performed across major healthcare databases (PubMed, EMBASE, Cochrane, CINAHL) without restrictions.
  • The review followed PRISMA guidelines, with the protocol registered in PROSPERO.

Main Results:

  • 37 studies met inclusion criteria from 1,764 identified articles.
  • Home-based programs involving pediatricians and nurses were most common.
  • Low hospital readmission rates (0-10%) and high therapy completion were observed; common complications included catheter-related infections and neutropenia.

Conclusions:

  • Home-based pediatric OPAT is frequently implemented, associated with cost savings and high satisfaction.
  • The review identifies key evidence gaps for future pediatric OPAT program development and standardization.
  • Synthesized evidence informs the organization, outcomes, and safety of pediatric OPAT.
Abstract

Keywords:
Anti-bacterial agentsAntiviral agents and antifungal agentsOutpatientsPediatrics

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