Abstract:
Background: The Outpatient Parenteral Antimicrobial Therapy (OPAT) Clinic at the Alberta Children’s Hospital (ACH) offers a vital service, enabling stable pediatric patients to receive intravenous (IV) antimicrobial therapy on an outpatient basis. Established in 1997, the program aims to reduce hospital admissions and enhance patient experience. Eligible patients with various infectious conditions receive initial treatment in the emergency department before transitioning to outpatient care. The program not only improves patient satisfaction but also minimizes the risks associated with hospital stays, such as hospital-acquired infections, while addressing the challenges of antibiotic stewardship and monitoring for potential complications. This study seeks to characterize OPAT outcomes in pediatric patients, filling a gap in existing literature.
Methods: We conducted a retrospective descriptive study reviewing records of patients under 18 years of age treated with IV antimicrobials as outpatients within the OPAT program. Data were collected from electronic hospital records from May 1, 2023, to May 31, 2024. All data entries were recorded in REDCap as our data management platform.
Result: The study included 902 pediatric participants, with 455 males (50.4%); 32.9% were 1-5 years of age, followed by 26.9% of 6-10 years of age. The most common diagnoses were cellulitis (15.7%), genitourinary (GU) infections (15.5%), dental infections (9.8%), and pneumonia (8.2%). Ceftriaxone was the primary IV antibiotic for GU infections, while cefazolin was commonly used for cellulitis and dental infections. Of the total participants, 8% required hospitalization due to worsening infection or to increase the frequency of antibiotics. Additionally, a higher rate of admission was noted in males (p = 0.03). Most patients (97%) received peripheral IV access with minimal complications. Overall, OPAT demonstrated high efficacy and safety in managing pediatric infections.
Conclusion: This study underscores the safety of OPAT. Supported by a multidisciplinary team, the program effectively treated common infections primarily using ceftriaxone. Most patients maintained peripheral IV access without significant complications. While hospitalization rates were low, notable differences between male and female patients warrant further investigation into contributing factors to these disparities.
Reference:Alsharrah D, Jadavji T. Evaluating Outpatient Parenteral Antimicrobial Therapy (OPAT) Clinic for Pediatric Infectious Conditions: Insights From Alberta Children’s Hospital. Can J Infect Dis Med Microbiol. 2026 Apr 5;2026:9586294. doi: 10.1155/cjid/9586294. PMID: 41947936; PMCID: PMC13051793.