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Previous Volume 337:829-839 September 18, 1997 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Over the past 20 years, outpatient parenteral therapy with antimicrobial drugs has proved effective, safe, and cost effective for patients with a wide range of infectious diseases.^1,2,3,4 Teams to manage this type of therapy have been established at medical centers,^5,6 emergency departments,⁷ health maintenance organizations,⁸ physicians' offices,^9,10 and other sites.

Indications

Three criteria must be met before outpatient parenteral antimicrobial-drug therapy can be implemented. The patient must have an active infectious disease that requires continued treatment beyond the anticipated period of hospitalization. There should be no further need for hospitalization, other than for treatment of the infectious disease. There must be . . . [Full Text of this Article]

Intravenous Catheters Used

Types of Catheters

            Midline Peripheral Intravenous Catheters

            Peripherally Inserted Central Venous Catheters

            Non-Tunneled Central Venous Catheters

            Tunneled Central Venous Catheters

            Implantable Subcutaneous Central Catheters

            Catheter Models and Ease of Use

Complications

            Noninfectious Complications

            Hypersensitivity Reactions

            Infectious Complications

            Prevention of Infectious Complications

Summary

Infusion Devices

Minibags plus Gravity

Electronic Syringe Infusion Devices

Elastomeric, Mechanical, and Electronic Infusion Devices

Multiple-Dose Electronic Infusion Pumps

Pharmacologic Considerations

Stability of Drugs Used for Outpatient Parenteral Therapy

Final Selection of Drug and Infusion Device

Cost Effectiveness of Outpatient Therapy

Summary

Source Information

From the Earle A. Chiles Research Institute, Providence Portland Medical Center, and the Department of Medicine, Oregon Health Sciences University, Portland.

Address reprint requests to Dr. Gilbert at the Department of Medical Education, Providence Portland Medical Center, 5050 N.E. Hoyt, Suite 540, Portland, OR 97213.

References

This article has been cited by other articles:

• Matthews, P. C., Conlon, C. P., Berendt, A. R., Kayley, J., Jefferies, L., Atkins, B. L., Byren, I. (2007). Outpatient parenteral antimicrobial therapy (OPAT): is it safe for selected patients to self-administer at home? A retrospective analysis of a large cohort over 13 years. J Antimicrob Chemother 60: 356-362 [Abstract] [Full Text]  
• Fernandez-Aviles, F., Carreras, E., Urbano-Ispizua, A., Rovira, M., Martinez, C., Gaya, A., Granell, M., Ramiro, L., Gallego, C., Hernando, A., Segura, S., Garcia, L., Gonzalez, M., Valverde, M., Montserrat, E. (2006). Case-Control Comparison of At-Home to Total Hospital Care for Autologous Stem-Cell Transplantation for Hematologic Malignancies. JCO 24: 4855-4861 [Abstract] [Full Text]  
• McNelis, J., Zarcone, J., Jurkiewicz, A. (2002). Outcome of Subcutaneously Implanted Catheters in a Teaching Hospital. American Journal of Medical Quality 17: 185-188 [Abstract]  
• Campo, M., Moreno, J. M., Albinana, S., Valero, M. A., Gomis, P., Leon-Sanz, M. (2001). Clinical Observation: Outpatient Intravenous Antibiotic Therapy for Catheter Infections in Patients on Home Parenteral Nutrition. Nutr Clin Pract 16: 20-24 [Abstract]  
• Shepperd, S., Harwood, D., Gray, A., Vessey, M., Morgan, P. (1998). Randomised controlled trial comparing hospital at home care with inpatient hospital care. II: cost minimisation analysis. BMJ 316: 1791-1796 [Abstract] [Full Text]