Outpatient parenteral antibiotic therapy (OPAT) in Asia: missing an opportunity

• Published in: Journal of antimicrobial chemotherapy 2017-04, Vol.72 (4), p.1221-1226
• Main Authors: Fisher, Dale, Michaels, Jessica, Hase, Ryota, Zhang, Jing, Kataria, Sushila, Sim, Benedict, Tsang, Joseph Kay-Yan, Pollard, James, Chan, Monica, Swaminathan, Subramanian
• Format: Article
• Language: English
• Subjects: Ambulatory Care - standards; Ambulatory Care - statistics & numerical data; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Asia - epidemiology; Communicable Diseases - drug therapy; Communicable Diseases - epidemiology; Humans; Infusions, Parenteral; Outpatients; Singapore - epidemiology
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkw551

Healthcare facilities internationally have grown outpatient parenteral antibiotic administration services for the last few decades. The literature contains publications from dozens of countries describing systematized processes with specialist oversight and their levels of service provision and outcomes. Such descriptions are absent in the majority of Asian countries. We sought to elucidate the extent and nature of outpatient parenteral antibiotic therapy (OPAT) in Asia and to consider the ramifications and opportunities for improvement. Utilizing colleagues and their personal networks, we surveyed healthcare facilities across 17 countries in Asia to ascertain the current means (if any) of providing OPAT. In that survey we also sought to explore the capacity and interest of these facilities in developing systematized OPAT services. Responses were received from 171 different healthcare facilities from 17 countries. Most (97/171, 57%) stated that they administer outpatient parenteral antibiotics, but only 5 of 162 facilities (3%) outside of Singapore described comprehensive services with specialist oversight. There is very likely a large unrecognized problem of unchecked outpatient parenteral antibiotic administration in Asia. Developing comprehensive and systematized OPAT in Asia is needed as a priority in an environment in which the infectious diseases community is demanding broad stewardship approaches. There are nonetheless challenges in establishing and sustaining OPAT programmes. Local champions and leverage off identified local incentives and needs are key to regional advancement.