Abstract:
:Outpatient parenteral antibiotic therapy (OPAT) programmes are effective, well tolerated and economically advantageous in carefully selected patient populations. Inclusion criteria for patient selection for OPAT include good clinical appearance and uncomplicated infection. By virtue of their favourable microbiological and pharmacological properties, cephalosporins in general, and ceftriaxone in particular, are the most widely prescribed antibiotics for OPAT worldwide. OPAT was largely created to prolong parenteral therapy following early discharge and has now been extended to community general practice. Indeed, more than 250000 treatments are performed in the US each year for a wide variety of serious infections, with an increase of 100% during the last 5 years. In 1994, an advisory committee was created in Canada to provide guidelines for home intravenous therapy. Of the 3 models that were defined (the visiting nurse model, the infusion centre model and the self-administration model), the OPAT self-administration model offers considerable cost savings and is probably largely utilised in a number of countries, such as Italy, where specific models have not been codified. Once the need for parenteral antibiotic therapy has been established, the choice of antibiotic is the second step in the decision-making process. Third generation cephalosporins are characterised by a number of important advantages in the OPAT setting, namely a favourable antibacterial spectrum, tolerability profile and patient compliance, as well as advantageous cost considerations. While the advantages of parenteral cephalosporin therapy in the ambulatory care setting outweigh the disadvantages in terms of cost effectiveness and rapid onset of action, adverse events such as pain at the injection site following intramuscular administration and phlebitis after intravenous infusion should be borne in mind.
journal_name
Drugsjournal_title
Drugsauthors
Esposito Sdoi
10.2165/00003495-200059003-00003subject
Has Abstractpub_date
2000-01-01 00:00:00pages
19-28; discussion 47-9eissn
0012-6667issn
1179-1950journal_volume
59 Suppl 3pub_type
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