Outpatient parenteral antibiotic therapy in Singapore

Nephrotoxicity of continuous versus intermittent infusion of vancomycin in outpatient parenteral antimicrobial therapy

“…vancomycin is increasingly used as outpatient parenteral antimicrobial therapy (OPAT) [1], driven by the continued emergence of antibiotic-resistant Gram-positive bacteria such as methicillin-resistant Staphylococcus aureus (MRSA). Although there are alternative agents active against MRSA [2], none have been shown to be superior to vancomycin in a prospective, randomised, controlled clinical trial.…”

A cost analysis of Outpatient Parenteral Antibiotic Therapy (OPAT): an Asian perspective

“…In Singapore, the first OPAT patients were enrolled 5 years ago [12]. However, the service attracted few patients initially, in large part due to local healthcare funding policies, which posed significant inadvertent financial disincentives.…”

“…This reform in healthcare funding policy was instrumental in the establishment of a designated OPAT centre at the National University Hospital (NUH), a 928-bed teaching hospital in Singapore, in October 2004. Currently, OPAT care in Singapore is generally provided through hospitalbased OPAT centres, which the patient must attend, in most instances, every day [12]. Administration by a care-giver utilising infusion pumps is now also employed for ca.…”

Outpatient parenteral ­antimicrobial therapy (OPAT) and the general ­physician

“…These are associated with line infections (at a rate of 0-3 per 1,000 OPAT patient days in published cohorts), while other line events, such as thrombosis and mechanical and chemical phlebitis, occur at higher rates (0.5-5 per 100 OPAT patient days). 3,[25][26][27] This underlines the need for specialist nursing involvement with intravascular device expertise in OPAT. Rates of healthcare associated infection (HAI) are lower than in hospitalised patients.…”