ABSTRACT
The advent of new potent antimicrobics with prolonged half-lives that can be infused over 30 to 60 minutes without sacrificing antimicrobial activity together with miniaturized infusion devices that allow for ease of administration have made OPAT a reasonable alternative to hospitalization. Additionally, economic pressures from third-party payers and managed care providers have promoted less expensive alternatives to hospitalization. New drugs with excellent bioavailability have expanded the types of infections being treated orally. Agents such as the flouroquinalones (ciprofloxacin, levofloxacin, gatifloxacin), macrolides (azithromycin), clindamycin, metronidazole, trimethoprim-sulfamethoxazole, and doxycycline are very well absorbed orally and should be used parenterally only if the patient is unable to take them orally. An approach to the patient being considered for OPAT is outlined in Figure 1. Infectious disease consultation should be considered prior to the initiation of OPAT to assist with patient selection, antimicrobial use, and type of venous access and to help with drug and complication monitoring.
