Evaluating Outpatient Parenteral Antimicrobial Therapy (OPAT) Clinic for Pediatric Infectious Conditions: Insights From Alberta Children’s Hospital

Background: Variability in outpatient parenteral antimicrobial therapy (OPAT) management and challenges to providing recommended OPAT care can compromise patient safety and care quality. Little is known about how OPAT is currently delivered by healthcare systems across the United States (US), including within the Veteran’s Health Administration (VHA). We sought to understand and compare OPAT delivery at selected Veterans Affairs medical centers. Method: Using a qualitative methodology, we conducted semi-structured interviews with key informants involved in OPAT delivery at 6 VHA medical centers with different complexity levels in the Midwestern US. Facility complexity is determined by patient volume and complexity level along with the amount of teaching and research conducted at the facility. Interviews occurred between February and December 2024 with healthcare personnel (n=30), including primary care and infectious diseases physicians, pharmacists, nursing staff, care coordinators, and vascular access providers. Data collection focused on better understanding OPAT processes within key domains of decision-making, patient education, care coordination, and post-discharge management. We used rapid analysis and a summary matrix to compare practices across sites within each domain. Result: Our findings highlight significant variability among VHA medical centers that provide OPAT to Veteran patients. Three of the 6 medical centers had dedicated OPAT programs as evidenced by a multidisciplinary team with clearly delineated roles and responsibilities, and processes that may help mitigate adverse outcomes and improve communication between providers at all OPAT care points. These processes map to the key elements outlined in the Infectious Diseases Society of America (IDSA) practice guidelines for OPAT programs, and include determination of appropriate therapy, patient education, lab monitoring, and discontinuation of treatment. (Figure 1) Conversely, at the three VHA sites without evidence of a multidisciplinary OPAT team or program, most participants described poor communication and coordination, lack of support, and uncertainty among providers about who is responsible for OPAT care. This confusion extends to follow-up and discontinuation of treatment. OPAT key elements were lacking or poorly defined. A process map helps visualize the contrasts in care between sites with and without defined OPAT programs. (Figure 1) Conclusion: Despite its centralized healthcare system, VHA medical centers demonstrate highly variable processes with respect to OPAT care. In the absence of a clear OPAT policy or program, uncertainty among providers about roles and responsibilities may be greater. The presence of a dedicated multidisciplinary OPAT team may help improve communication and care coordination, thereby minimizing quality and safety concerns.

Current literature reports that outpatient parenteral antimicrobial therapy (OPAT) programs improve cure rates, and reduce length of hospitalization and costs. OPAT programs are still relatively new in Canada. To evaluate the benefits of an OPAT program initiated at a multispecialty tertiary care facility in Toronto, Ontario, compared with the previous standard of care. The present retrospective observational study was conducted using data from a group of surgical patients who were treated for active infections. Between February 1, 2010 and November 30, 2010, a total of 108 surgical patients were enrolled in the OPAT program. Patients were matched 1:1 with historical controls discharged between January 1, 2001 and January 1, 2010 according to age, sex, type of surgery, infection and comorbidities (Charlson Comorbidity Index). Cure rate, 30-day rehospitalization and length of stay were evaluated as primary end points. Of 108 eligible OPAT patients, 21 were matched to the control group using the prespecified criteria. For this cohort, the OPAT program was associated with improved cure rates (OPAT 61.7% versus control 57.1%; P>0.10), reduction in rehospitalization rate (14.3% versus 28.6%; P>0.10) and reduced length of stay (10.7 versus 13.9 days, P>0.10) compared with the control group. For this cohort of surgery patients, the OPAT program demonstrated a trend toward improved outcomes but did not achieve statistical significance. Due to the lack of statistical power, further evaluation is required to determine the full benefit of OPAT to patients and the health care system.

Objectives: Piperacillin/tazobactam (P/T) is a broad-spectrum β-lactam antibiotic frequently used in outpatient parenteral antimicrobial therapy programs (OPAT). We aim to compare the clinical outcomes of P/T treatment in two models of OPAT care in order to maximize the utilization of health resources. Material and methods: We conducted a prospective observational study with retrospective analysis of a cohort of patients treated with P/T delivered every 24 or 48 h in an OPAT program. The primary outcomes were treatment failure during the OPAT episode and 30 day treatment failure. A bivariate and multivariate logistic regression model was built. A two-sided p < 0.05 was considered statistically significant. Results: Between 2012 and 2022, 247 patients were treated with P/T. Treatment was delivered daily in 176 patients (Group 24) and every two days in 71 patients (Group 48). The rate of treatment failure during OPAT in Group 24 and Group 48 was 12.4% (n = 22) and 5.6% (n = 4), respectively (p = 0.112); and the rate of treatment failure 30 days after OPAT treatment end was 18.2% (n = 32) and 21.1% (n = 15) in Group 24 and Group 48, respectively (p = 0.594). Treatment every 24 or 48 h was not associated with higher treatment failure during OPAT or 30 days after finishing OPAT in either bivariate or multivariate analysis. Conclusions: P/T administration in OPAT programs being replaced every two days is feasible without an increase in treatment failure, relapse, or mortality compared to daily drug replacement. These findings should motivate further research to facilitate the implementation of this novel delivery strategy in OPAT programs.

Background/Objectives: In 2022, Spaarne Gasthuis hospital implemented an outpatient parenteral antimicrobial therapy (OPAT) programme, including mandatory infectious disease (ID) specialist assessment and integrated structured workflow, aiming to improve quality of care, optimize antimicrobial use, and reduce healthcare costs. Our objective was to evaluate the impact of the OPAT programme on patient outcomes (IV duration, clinical response, adverse clinical outcomes, timely peripherally inserted central catheter (PICC) removal), antimicrobial stewardship parameters, and healthcare costs. Methods: This retrospective before–after cohort study used electronic health record data to compare patients treated with outpatient parenteral antimicrobial therapy before (2019) and after (August 2022–December 2024) OPAT programme implementation. Using linear and logistic regression analyses, the association between the independent variable (pre-OPAT vs. OPAT) and outcomes were assessed and adjusted for potential confounders (sex, age, department, primary and additional indications). Cost analysis was performed, and ID specialist-recommended therapy adjustments were evaluated. Results: In total, 529 patients were included: 118 in the pre-OPAT group, and 411 in the OPAT group. In 36.3% of OPAT cases, therapy was adjusted, thereby optimizing antimicrobial stewardship. The OPAT programme was associated with significantly shorter IV therapy duration of 13.97 (mean) days (95%CI −9.15–−18.79; p < 0.001), significantly less meropenem use (p < 0.001), and significantly less adverse clinical outcomes (OR 0.58, 95%CI 0.37–0.92; p = 0.021), whereas no significant difference was found in clinical response (OR 1.22; 95%CI 0.67–2.32; p = 0.527). The programme led to cost savings of 3.343 EUR per patient. Conclusions: The OPAT programme optimized antimicrobial use and reduced IV therapy duration, adverse clinical outcomes, and healthcare costs.

BackgroundAlthough it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program.MethodsThis retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p< 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission.ResultsDemographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2.Table 1. OPAT Patient Demographics and Factors Pre- and Post-interventionTable 2. Factors independently associated with hospital readmission in OPAT patientsConclusionAn OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future.DisclosuresAll Authors: No reported disclosures

Corresponding Author: Zachary Howe, 705 Riley Hospital Drive SFT Room W6111, Indianapolis, IN 46228, 317-948-9562, zhowe@iuhealth.org No conflicts of interest Background Characteristics of pediatric outpatient parenteral antimicrobial therapy (OPAT) are not well described, and multidisciplinary programs are relatively rare. The primary aim of this study was to describe specific OPAT use, commonly encountered barriers, and clinical outcomes in patients from a newly established OPAT program at a tertiary children’s hospital. Methods A multidisciplinary OPAT program was established at Riley Hospital for Children in December 2021. Inpatient services were gradually included until all services were enrolled as of March 2023. Medical record data related to patient selection, the chosen antimicrobial regimen, and safety/efficacy outcomes were prospectively collected for patients completing OPAT during the year after go-live with all services (March 2023-February 2024). Results Among 90 OPAT courses during the study period, CNS and central line infections were the most common indications (30.0% and 34.4%, respectively). The most common interventions made by the OPAT pharmacist were changes in dose (30.0%), frequency (32.2%), and agent selection (56.7%) with a median of 3 interventions being made per patient (IQR 4). The most frequent IV antimicrobials utilized were ceftriaxone (25.6%) and vancomycin (12.2%), and the most reported adverse effects were acute kidney injury (5.6%) and neutropenia (ANC&amp;lt;1000 cells/mm3; 4.4%). Eighteen percent of cases were re-hospitalized during their OPAT course, most frequently due to reasons unrelated to their infection (33.3%) or due to need for another source control procedure (33.3%). There was no difference in likelihood of readmission between patients with and without home nursing care (53.3% vs 46.7%, p=0.35). Modifications to original OPAT treatment plans were noted in 12.2% of cases, and patients received IV antimicrobials for a median of 19 days (IQR 34 days). Conclusion Multidisciplinary pediatric OPAT programs are rare but have the potential to optimize antimicrobial selection and provide more structured monitoring and patient follow-up. Studies with larger cohorts of patients are needed to fully elucidate necessary resources that will overall enhance OPAT care and improve patient outcomes.

Background Outpatient parenteral antimicrobial therapy (OPAT) refers to the delivery of parenteral antimicrobial treatment in at least two doses on different days without hospitalization required. Implemented antimicrobial stewardship programs (ASP) have reported significant reductions in unnecessary antibiotic prescriptions and improved patient outcomes. At the Salisbury Veterans Affairs Health Care System (SVAHCS), the OPAT program enrolls approximately 150 Veterans annually to which 86% of OPAT requests originate outside of VA care. The purpose of this study was to evaluate the efficacy and safety of OPAT along with ASP practices at SVAHCS.Clinical Characteristics and Most Common OPAT AntimicrobialsOPAT Indications Methods This quality improvement project was conducted as a retrospective cohort study on eligible Veterans on OPAT between January 2022 through December 2024. The main objective was to assess the efficacy of OPAT. The primary outcome was readmission rates to a hospital while receiving OPAT due to complications, adverse events, treatment failure or for reasons unrelated to infection or OPAT regimen. Secondary objectives included evaluating safety, 30-day mortality post-OPAT, 30-day readmissions post-OPAT, rate of OPAT completion, the reduction of hospital bed days of care (BDOC) and intravenous (IV) line days avoided, ASP interventions and potential cost savings.PAT Readmissions during OPAT and Associated ReasonsOPAT ASP Interventions and Potential Cost Savings Results A total of 398 Veterans were included in this study with 53 (13%) readmissions during OPAT. Of those readmissions, 15 (28%) were secondary to antibiotic failure, 11 (21%) were due to adverse effects and 27 (51%) for concomitant diseases. There were five deaths which equates to a post-OPAT 30-day mortality rate of 1%. Nine readmissions (2%) occurred within 30 days post-OPAT with 2 (22%) due to antibiotic failure, 1 (12%) secondary to adverse effect and 6 (66%) for concomitant diseases. The OPAT completion rate was 97%. A mean of 3,337 BDOC and 134 IV line days were avoided annually. A total of 4,575 ASP interventions associated to OPAT were documented with potential cost savings of $611,669. Conclusion The OPAT program and ASP at SVAHCS effectively manage Veterans with low 30-day mortality and adverse effect rates, high OPAT completion rate and comparable readmission rates to current literature while diligently implementing ASP interventions with associated potential cost savings. Disclosures All Authors: No reported disclosures

The development and implementation of a pharmacist-managed outpatient parenteral antimicrobial therapy (OPAT) program in a county teaching hospital are described. A pharmacist-managed OPAT program was developed and implemented at a county teaching hospital to provide consistent evaluation, approval, and monitoring of patients requiring OPAT for the treatment of infection. The developmental and implementation stages of the OPAT program included (1) a needs assessment, (2) the identification of resources necessary for program operation, (3) delineation of general OPAT program operations and activities of individual OPAT clinicians, (4) the development of patient selection criteria, including a plan of care algorithm, and (5) acquisition of administrative support to approve the program. In this program, the OPAT pharmacist plays an integral role in the management and oversight of OPAT patients, working under a collaborative agreement with infectious diseases physicians. The OPAT pharmacist assists with appropriate patient and regimen selection, confirmation of orders on discharge, assuring that laboratory tests for safety surveillance are performed and evaluated, performing routine monitoring for adverse events and line complications, and assuring the removal of the vascular access device upon the completion of OPAT. The OPAT program provides structured monitoring, patient follow-up, and led to improvements in patient outcome with minimization of treatment and line-related adverse events.

Background Outpatient parenteral antimicrobial therapy (OPAT) programs have reduced readmissions without impacting emergency center (EC) visits. Our initial pilot OPAT program improved laboratory monitoring without decreasing readmissions or EC visits. We expanded the program and made additive quality improvement interventions. Outcomes Associated with Outpatient Parenteral Antimicrobial Therapy Interventions in Patients Receiving Care at a Comprehensive Cancer Center *Previously published initial pilot program. **Compared with baseline among patients with &amp;gt;/= 1 EC visit. OPAT, Outpatient parenteral antimicrobial therapy; APP, advanced practice provider; EMS, electronic medical system; EC, emergency center; ID, infectious diseases Methods We obtained demographic data and baseline frequencies of 30-day unplanned readmissions and EC visits from our electronic medical system (EMS) for 48 patients over 6 weeks prior to pilot implementation. Using the Model for Improvement, we made iterative additions, including pharmacist regimen review, monitoring within the EMS, online commercial laboratory result access, weekly nursing phone calls after discharge, and expansion to infectious disease outpatient starts. After interventions, we compared categorical variables to baseline by using Chi-square or Fisher’s exact test, as appropriate, and compared continuous variables by using nonparametric Wilcoxon rank sum test. We performed multivariable logistic regression to identify risk factors independently associated with readmission. Results During June 2018–November 2023, our OPAT program provided care for 1,274 patients. Readmissions decreased from 30% to 15% (p = 0.02) (Figure). Mean number of EC visits per patient decreased (1.3 vs. 1.0, p = 0.002). In multivariable analysis, EMS monitoring and online access to laboratory results were independently associated with decreased readmission risk (aOR 0.22 [95% CI: 0.09-0.56]). Nursing calls after discharge independently protected against readmission (aOR 0.18 [95% CI: 0.07-0.47]). Patients with Eastern Cooperative Oncology Group-Performance Status ≥2 were readmitted more often than those with &amp;lt; 2 (aOR 1.63 [95% CI: 1.05-2.52]). Conclusion Improving efficiency and access to laboratory data and weekly nursing phone follow up were associated with fewer readmissions among OPAT patients with cancer. This study is the first, to our knowledge, to show an impact of OPAT on EC visits in any population. OPAT patients with poor functional status have an increased risk for readmission and may benefit from closer monitoring. OPAT programs can improve safety for adult patients with cancer despite competing risks inherent to this population. Disclosures Natalie J Dailey Garnes, MD, MPH, MS, AlloVir: Grant/Research Support

Outpatient parenteral antimicrobial therapy (OPAT) programs continue to evolve with increases in multidisciplinary teams, complex oral antibiotics, long-acting injectable antimicrobials, patients with substance use disorder (SUD) and telehealth. We sought to examine how OPAT programs are currently structured and identify barriers to safe care. Cross-sectional survey. Physician, pharmacist, and advanced practice providers (APP) Emerging Infections Network (EIN) members. A survey was conducted between February and March 2025 to assess OPAT structure, expansion to complex outpatient antimicrobial therapy (COpAT), and barriers to safe OPAT care. Of 1639 EIN members, 622 (38%) responded; 75% reported an active role in OPAT. Oversight of patients on COpAT was reported by 59%, and mandatory ID consultation for OPAT by 59%. Eighty-one percent reported >75% of OPAT patients were followed by ID. Most patients received OPAT at home (78%) followed by post-acute care facilities. Outpatient and inpatient ID physicians were responsible for laboratory test monitoring (75% and 30% respectively), while 37% reported a multidisciplinary OPAT team and 32% reported non-specialists. Respondents cited inadequate support in data analysis, administration, information technology and financial support for clinical staff. Common challenges were lack of leadership awareness (51%), difficulty managing patients with SUD (50%) and timely access to laboratory test results (48%). ID physicians were commonly involved in OPAT care, with many programs expanding to COpAT. Several barriers to the safe delivery of OPAT remain, including lack of institutional support, reimbursement and poor communication between stakeholders.

Review of the first comprehensive outpatient parenteral antimicrobial therapy program in a tertiary care hospital in Japan

ObjectivesTo describe the implementation process, safety, and efficacy outcomes, as well as cost-effectiveness, of the first outpatient parenteral antimicrobial therapy (OPAT) program to utilize disposable elastomeric pumps in the Kingdom of Saudi Arabia and the entire Gulf region.MethodsThis OPAT program was initiated in May 2018 and was administered through a multidisciplinary team that included the home medicine department, pharmacy department, nursing department, and the infectious diseases service. The device used was the Intermate® (Baxter, Deerfield, Illinois) elastomeric pump. After consultation with an infectious diseases physician, eligible patients were discharged home to complete the remainder of their antimicrobial treatment, which was self-administered via the elastomeric devices.ResultsFrom May 2018 to December 2019, 47 patients received 55 courses of OPAT via the new program. A total of 2,869 pumps were used during that period to provide 927 days of antimicrobial therapy in the home setting. Most patients completed the program successfully with no reported significant OPAT-related complications such as catheter-related infections. Four patients were re-admitted for relapse of infections and one patient was re-admitted for colistin-induced nephrotoxicity. No mortality was reported for any patient during OPAT treatment and 30 days after program completion.ConclusionsThe implementation of this novel OPAT program was safe, effective, and offered significant cost-savings to our institution. The entire process was very dynamic and was centered around proper patient selection and education as well as excellent communication between patients and the entire multidisciplinary team involved in the program. We hope that these results will encourage other institutions in the region to implement similar OPAT programs to alleviate the existing bed crisis due to the ongoing COVID-19 pandemic.

ObjectivesPeriprosthetic joint infection (PJI) is a complication of joint arthroplasty and is seen in 1-2% of cases. Since its initiation in 2013, the national outpatient parenteral antimicrobial therapy (OPAT) program has facilitated the outpatient management of intravenous antimicrobials for PJI. This study aims to describe the clinical epidemiology of patients on OPAT with PJI between 2013 and 2021. MethodsA retrospective analysis of patients discharged on OPAT between January 1, 2013 to August 31, 2021 was performed using data available from the national OPAT program. This study focused on those with a PJI. Data were analyzed using STATA/SE version 17.0. ResultsFrom January 1, 2013 until August 31, 2021, there were 14,749 patients managed through the national OPAT program, 8.35% (1232 of 14,749) of which were PJI. Of these, 53% (653 of 1232) were hip arthroplasty, 22.7% (280 of 1232) were knee arthroplasty, and 24.3% (299 of 1232) were “other.” The mean age was 64.5 years (SD 14.15 years). Of those on OPAT, 66.15% (815 of 1232) were health care–administered OPAT, whereas 33.85% (417 of 1232) were self-administered (S) OPAT (S-OPAT). Patients on S-OPAT were statistically younger (61 vs 66 years old, P <0.001, 95% confidence interval 14.1-63.6). The most common antimicrobial prescribed was daptomycin (35.8%; 441 of 1232), followed by ceftriaxone (21.2%; 262 of 1232). The median duration on the OPAT program was 27 days (interquartile range 14.5-35 days). ConclusionOPAT use in PJI is growing. Cumulatively, it has saved 26,992 hospital bed-days. Although S-OPAT is the preferred strategy and should be considered for all patients, our data demonstrate that health care–administered OPAT is required more frequently in older patients.

Background Outpatient parenteral antimicrobial therapy (OPAT) is often overseen by multidisciplinary teams in infectious diseases (ID) provider groups. OPAT programs serve an important role in health systems to decrease inpatient length of stay and ensure safe transitions of medically complex patients. The optimal composition and staffing needs of OPAT teams are not defined. To gauge challenges facing OPAT program administration and provide insights for those initiating an OPAT program, we described trajectories in patient volume throughout our OPAT program. Methods We included all UNC OPAT courses from inception in 2015 through 2023. The OPAT team mainly provides care for home infusion OPAT, providing lab monitoring, assessment of adverse events, and care coordination. The OPAT team does not cap enrollment and currently accepts patients seen by general ID providers who require &amp;gt;14 days parenteral antimicrobials. OPAT team staffing has varied since inception. It is currently primarily administered by a nurse and a pharmacist, with support from a scheduler and an ID physician. We calculated the average monthly census of patients followed by the OPAT team over time. Census was defined as the number of outpatients followed by the OPAT team at a time. To gain granular detail we also trended the average weekly OPAT census in 2022 and 2023. Results 2,878 OPAT courses were cared for by the OPAT team. Median days on OPAT was 35. The most common diagnoses were osteomyelitis (43%), bacteremia (20%) and diabetic foot infection (12%). Average monthly OPAT census overall increased since inception (Fig 1) and demonstrated marked monthly variation across the entire period. In 2022-2023, the weekly census ranged from 32 to 60 patients, with a median weekly census of 45 patients (IQR, 41-50) (Fig 2). Conclusion We found our OPAT census underwent frequent, wide fluctuations in volume, which was met with adjustments in task prioritization and approach to accommodate surges. Of note, the OPAT team provides assessment and transition management for referred patients prior to discharge. These patients are not counted in census but are a key area to improve safety and stem readmission. Our results demonstrate that OPAT workload can be volatile and needs robust, expert staffing to meet unpredictable demands and patient needs. Disclosures Asher J. Schranz, MD, MPH, UpToDate: I receive fees for authorship of an UpToDate article.

BackgroundThe UNC Medical Center OPAT program was started in 2015 to provide multidisciplinary management of medically complex patients referred by the infectious diseases (ID) inpatient services and discharged on parenteral antimicrobials. A primary aim of the program is to avert avoidable readmissions during OPAT therapy through protocolized laboratory monitoring, case review and streamlined access to ID urgent care services.MethodsWe abstracted electronic health records for the first 250 patients enrolled in the OPAT program. 223 patients with sufficient recorded data for entire OPAT course were included. All-cause readmission events during OPAT therapy were collected, and cause for readmission was adjudicated by a multidisciplinary committee.ResultsOf the 223 patients, 62% were male with median age 53 years (20–88). 39 (17%) experienced a readmission (Table 1). Most readmissions occurred among patients not seen in our OPAT urgent care for the admitting complaint. 57 patients (26%) experienced at least one adverse drug reaction (ADR), e.g., laboratory abnormality, rash, or diarrhea; 7 of these required readmission. ADR was the most common reason for ID urgent care visit. Almost half of readmissions were unrelated to OPAT therapy or OPAT-related diagnosis. Less than 10% of OPAT patients utilized ID urgent care services; none of these visits resulted in readmission.ConclusionOur OPAT program represents a medically complex cohort that may be at higher risk of readmission at baseline. The availability of providers and pharmacists for urgent care services is effective in avoiding readmission for OPAT-related causes. Future interventions to address common causes of readmission include expanded access to urgent care servvices and close interval follow-up after discharge for particularly high-risk patients.Table 1. Reason for readmission of OPAT patientsaReasonNo. (n = 39)% of readmissionsUnrelated to OPAT-indicated diagnosisb1744Clinical failure923OPAT drug-related adverse eventc718New infectiond513Unspecified13a 184 out of 223 (83%) OPAT patients were not readmitted. b e.g., myocardial infarction, stroke, alcohol consumption. c e.g., kidney or liver dysfunction. d e.g., OPAT for endocarditis subsequent urinary tract infectionDisclosuresAll authors: No reported disclosures.