Analysis of outpatient and home parenteral intravenous antibiotic therapy (OHPAT) cases at the Newcastle upon Tyne Hospitals NHS Foundation Trust from April 2017 to June 2019

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Introduction and Methods Newcastle’s OHPAT service has been operating since 2011, providing intravenous antimicrobials on outpatient basis for deep seated infections (DSI) and skin and soft tissue infections (SSTI); either provided at the OHPAT service in hospital (H-OPAT), delivered to the patient’s home (C-OPAT) or self-administered by an instructed patient (S-OPAT). The service aims to reduce admissions and inpatient bed days. Data from a prospective database was analysed to determine bed days saved, admissions avoided, location and success rate of treatment and adverse outcomes. Results 292 patients (174 male, 118 female) median age 54 (range 17– 97) April 2017-June 2019. 148 patients with SSTI and 143 DSI. 140 patients previously treated as inpatients. 141 admissions avoided; 3540 bed days saved; 267 patients treated with H-OPAT; 21 C-OPAT; 4 S-OPAT. High cure rate of 100% in SSTI and 97% in DSI (3 re-admissions, 1 self-discharge). Low complication rate with no death, MSSA/other bacteraemia or CDT-associated diarrhoea. Low complication rate of 0.7%: rash in 1 patient (on ceftriaxone) and line blockage in 1 patient. Conclusion The aim of the OHPAT service is equality of effectiveness and safety compared to inpatient care. This has been achieved in the ongoing low rate of complications and adverse outcomes. The service treated a wide range of DSI which contribute a larger proportion of bed days for much fewer cases than SSTI. Significant numbers of hospital stays were avoided or shortened. OHPAT has been able provide complex regimes with home delivered and self-administered dosing.

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