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The evolution of outpatient parenteral antibiotic therapy
  1. Sanjay Valabh Patel
  1. Correspondence to Dr Sanjay Valabh Patel, Department of Paediatric Infectious Diseases and Immunology, University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; sanjay.patel{at}uhs.nhs.uk

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Managing children on intravenous antibiotics (IVABs) at home is not new. The origins of outpatient parenteral antibiotic therapy (OPAT) can be traced back to the 1970s, initially for children with cystic fibrosis.1 Managing children at home offers clear benefits in terms of parent and patient satisfaction, psychological well-being, return to school/employment and reductions in healthcare-associated infections; as a result, children are being routinely ambulated on IVABs from paediatric units in Europe and elsewhere. However, there has been a recent resurgence of interest in this area, driven in part by the severe financial constraints being faced by hospitals, making OPAT an attractive option for reducing operational costs through reduced inpatient stays. The British Society of Antimicrobial Chemotherapy (BSAC) has recently published paediatric OPAT guidelines.2 The focus of these recommendations, as well as the majority of the research literature, has been the management of children with complex infections requiring prolonged courses of IVABs.

Hodgson et al3 describe a large prospective cohort of children managed within an OPAT service in Australia. They attempted to …

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