Clinical efficacy, cost-analysis and patient acceptability of outpatient parenteral antibiotic therapy (OPAT): a decade of Sheffield (UK) OPAT service

Outpatient parenteral antimicrobial therapy (OPAT) has evolved relatively slowly in the UK. This study describes the OPAT service based in a large UK teaching hospital in Sheffield, and examines the clinical efficacy, patient acceptability and costs saved over a 10-year period. Data on 3812 episodes of OPAT treatment administered between January 2006 and January 2016 were retrieved from a prospectively maintained electronic database. We compared the real costs of the OPAT service with estimated costs of conventional inpatient care for these patient episodes. We also analysed patient feedback questionnaires that were randomly administered between January 2014 and January 2015. A wide range of infections were managed during the 10-year period. Skin and soft tissue infections accounted for 57% of OPAT episodes. The total number of bed days saved was 49854. A successful outcome (cure or improvement) was found in 3357 (88%) episodes. Readmission occurred in 265 (7%) episodes. The rates of healthcare-associated infections were low: 15 intravenous line-related infections were recorded (0.3 per 1000 OPAT patient days). Patient acceptance and satisfaction with OPAT were high. OPAT cost 15%, 39%, 40% and 44% of inpatient costs respectively for an infectious diseases unit, national average costs, for other departments (non-infectious diseases unit), and the minimum national average costs for each diagnostic category. This study shows that OPAT is safe, clinically efficacious and acceptable for treating a wide range of infections with high levels of patient satisfaction and substantial cost savings.