Multicentre insights into OPAT: a comprehensive analysis of Türkiye's unstructured system

Outpatient parenteral antimicrobial therapy (OPAT) is a well-established, cost-effective treatment modality delivered through structured, multidisciplinary programs worldwide. In Türkiye, no standardized OPAT framework exists; patients continue therapy through emergency departments, primary care facilities, or privately funded nursing services. This is the first multicentre study to evaluate clinical outcomes, treatment adherence, and patient satisfaction with OPAT in Türkiye.

This prospective multicentre study enrolled adult patients receiving OPAT for chronic osteomyelitis, spondylodiscitis, prosthetic joint infection, or urinary tract infection across 20 hospitals in Türkiye between March and August 2024.

A total of 265 patients were included (53.2% male; mean age 61.4 ± 13.5 years). Gram-positive pathogens predominated (60.2%); the most frequently used antibiotics were teicoplanin (70.5%), ceftriaxone (16.6%), and aminoglycosides (6.8%). The clinical success rate was 94.3%. ADEs led to treatment discontinuation in only 3 patients (1.1%). OPAT initiated at university hospitals was significantly more likely to be continued via emergency departments than at state hospitals (p = 0.010). Treatment-related adverse events occurred significantly more frequently outside dedicated OPAT units (18% vs. 3.1%; p = 0.030). Patient satisfaction was high overall; however, urinary tract infection patients reported significantly greater satisfaction than those with bone and joint infections across multiple domains. Additionally, patients treated in dedicated OPAT units reported significantly higher satisfaction than those treated in emergency departments across all domains assessed.

The absence of a structured OPAT system in Türkiye increases emergency department burden and elevates complication risk. Despite this, high clinical success rates and patient satisfaction support OPAT's potential as a viable alternative to inpatient care. A standardized, multidisciplinary OPAT framework is needed to improve patient safety and optimize healthcare resource utilization.