Abstract
Since the 1970s, outpatient parenteral antimicrobial therapy (OPAT) has been a viable option for patients who require intravenous antibiotics when hospitalization is not warranted. While the benefits of OPAT as a measure to improve the efficiency of healthcare delivery (i.e., reduced hospital days) and patient satisfaction are well-documented, OPAT is associated with a number of challenges, including line complications and reliance on daily healthcare interactions in some cases at home or in a clinic. To minimize the continued need for intensive healthcare services in the outpatient setting, there is trend toward patients self-administering antibiotics at home without the presence of healthcare workers, after adequate training. In most cases, patients administer the antibiotics through an established intravenous catheter. While this OPAT practice is becoming more accepted as a standard of care, the potential for line complications still exists. Outpatient subcutaneous antimicrobial therapy (OSCAT) has become an increasingly accepted alternative route of administration of antibiotics to IV by French infectious diseases physicians and geriatricians; however, currently, no antibiotics are approved to be administered subcutaneously. Antibiotics with longer half-lives that are completely absorbed and have a favorable local tolerability profile are ideal candidates for OSCAT and have the potential to maximize the quality and efficiency of parenteral antibiotic delivery in the outpatient setting. The increasing development of wearable, on-body subcutaneous delivery systems make OSCAT even more viable as they increase patient independence while avoiding line complications and potentially removing the need for direct healthcare professional observation.
Highlights
Outpatient parenteral antimicrobial therapy (OPAT) is defined by the Infectious Disease Society of America (IDSA) as the administration of parenteral antimicrobial therapy in at least two doses on different days without intervening hospitalization
We review the current published literature on SC administration of antibiotics in the outpatient setting, their PK properties by SC administration, identify the parenteral antibiotics best suited for SC administration, and review the potential use of wearable, on-body SC drug delivery systems that can be used to facilitate outpatient subcutaneous antimicrobial therapy (OSCAT)
OSCAT is an attractive alternative to the intravenous route of administration traditionally associated with OPAT
Summary
Outpatient parenteral antimicrobial therapy (OPAT) is defined by the Infectious Disease Society of America (IDSA) as the administration of parenteral antimicrobial therapy in at least two doses on different days without intervening hospitalization. OPAT has some drawbacks including the potential need for daily healthcare practitioner assessments due to the significant rate of catheter-related complications that can arise. The potential for IV catheter complications still exists with this practice, and there has been growing interest toward outpatient subcutaneous antimicrobial therapy (OSCAT) whereby the reliance on IV catheters can be eliminated. We [1] describe the limitation of current IV administration OPAT practices, [2] review available published data on SC administration of antibiotics in the outpatient setting, including PK data, [3] discuss the characteristics of parenteral antibiotics best suited for SC administration, and [4] review the potential use of wearable, on-body subcutaneous (SC) drug delivery systems that can be used to further facilitate the utility of OSCAT
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
