In their conclusion, the authors note that the majority of the studies of outpatient parenteral antimicrobial therapy (OPAT) report descriptive findings; in addition there was substantial clinical and methodological heterogeneity between studies which meant that results could not be pooled for meta-analysis.
Based on the findings of their review, the authors comment that there is “a dearth of information around key aspects of OPAT”, despite its increased use in the UK in recent years (stated likely to be due, in no small part, to the expectation that it would increase hospital inpatient capacity and improve patient experience). There is a lack of robust evidence upon which to base best practice recommendations; current guidance from the British Society for Antimicrobial Chemotherapy (see link below) is a consensus statement largely derived from expert opinion.
Further research is needed to determine the cost-effectiveness of different IV antibiotic services and patient preferences, to help identify the most appropriate service configuration. Few studies reported appropriate detail on the individual delivery models used and on patient complexity; the authors comment that reporting such detail in future studies is crucial, to enable identification of best practice and to help support local decision-making.