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The Infectious Diseases Society of America's updated Clinical Practice Guidelines emphasize the role of infectious disease specialists in ensuring that patients receiving outpatient parenteral antimicrobial therapy, or OPATs, are treated appropriately.
According to updated guidelines, all OPAT prescriptions must be reviewed by a physician, nurse or pharmacist before patient treatment begins and adjusted as needed. Once treatment is in progress, patients should be monitored regularly.
Since the publication of the previous guidelines in 2004, research has shown that OPAT was safe and preferred by patients, and that consultation with a specialist in ID on treatment reduced admissions to patients. hospital and spending on health care.
IDSA noted that an identity specialist often recommended that a patient be given oral antibiotics rather than intravenous antibiotics, and that some patients would not receive antibiotics intravenously, and that some patients would not receive antibiotics by mouth. may not even need antibiotics.
"The majority of patients referred for OPAT therapy need it, but in many cases, an oral antimicrobial would do the trick," Anne H. Norris, MD, Co-Chair of the Guidelines and Associate Professor of Clinical Medicine at the Perelman School of Medicine at the University of Pennsylvania, said in a press release.
"Given the growing problem of overuse and antimicrobial resistance around the world, any possibility of defusing these drugs is of paramount importance," Norris said. "Not only does this provide good antimicrobial management, [it] reduces costs and potentially improves the well-being of patients. It is always best to avoid intravenous access where possible, and narrower spectrum antimicrobials kill less healthy bacteria than larger spectrum agents. "
The updated guidelines do not offer recommendations on the treatment of specific infections and are not meant to replace clinical judgment in the management of individual patients, noted the authors.
Other new recommendations include indications for vancomycin OPAT, patients without allergies, use of medial catheters and blood clots in patients with central catheters inserted at the periphery.
Reference:
Norris AH, et al. Clin Infect Dis. 2018; doi: 10.1093 / cid / ciy745.
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