What is OPAT?
Outpatient parenteral antimicrobial therapy (OPAT) is the delivery of intravenous antimicrobials in the community as an alternative to inpatient care.
OPAT can be a suitable option for patients who are medically fit for discharge but require prolonged IV antibiotic therapy. Patients must have suitable IV access e.g. PICC line – please liaise with the IV access team.
If your patient is a candidate for OPAT:
- Do they have suitable vascular access in place?
- If not have they been referred to the IV access team? (Aintree: Bleep 5484) (Royal: Ext 3342)
- Is there an electronic referral for OPAT on Sigma/ICE?
- Has the OPAT been approved by microbiology/OPAT team? (Aintree site: Is the proforma clinic letter on sigma?)
- Has the TTO been prepared with the relevant OPAT medications (including flushes)?
- Is appropriate follow-up in place, including a follow up clinic appointment prior to completion of treatment.
- Have the community teams referral forms been completed and sent off?
- Has the OPAT checklist been completed before the patient is discharged?
Follow up/ Levels
OPAT patients require careful monitoring and follow up in the community to ensure treatment efficacy and avoidance of unnecessary side effects. This will include weekly blood tests, therapeutic drug monitoring and clinical / microbiological review.
Appropriate follow-up appointment should be in place before the patient is discharged, this should be clearly recorded in the discharge letter. Weekly bloods should be taken by community team; these should include any necessary therapeutic drug monitoring levels, for example teicoplanin.
If patient has any out of range teicoplanin levels they should be communicated to one of the antibiotic pharmacists at Aintree on extension 3987. At the royal site these will be followed up by the OPAT team.
Please ensure any details about monitoring requirements are clearly documented on the discharge summary.
It must be noted that the patient remains under the care of the parent team until OPAT is complete.
The hospital team
The community team
Sefton (Merseycare)
Contact details: 0151 475 4280
Liverpool (Merseycare)
Contact details: 0845 345 0878
St Helen's and Knowsley
Contact details: 01925 454 814
Warrington and Halton
Additional guidance specific to each hospital site
Aintree site:
All patients who are thought to be suitable for OPAT MUST have an electronic OPAT referral on Sigma, completed by the clinical team. If suitable the microbiologist will confirm antibiotic plan and an OPAT proforma will appear as a clinic letter on Sigma. At this point the patient will be referred to their local community IV team via the OPAT coordinator; the patient will be accepted if there is sufficient capacity. The team will contact the ward directly when they can accept patient into their care.
Royal site:
All patients who are thought to be suitable for OPAT MUST have an electronic OPAT referral on ICE, completed by the clinical team. If suitable the OPAT team will confirm the antibiotic plan and will document on PENS. At this point the patient will be referred to their local community IV team via the OPAT coordinator; the patient will be accepted if there is sufficient capacity. The team will contact the ward directly when they can accept patient into their care.