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What is Outpatient Parenteral Antimicrobial Therapy (OPAT)?

Outpatient Parenteral Antimicrobial Therapy (OPAT) offers patients the opportunity to receive intravenous (IV) antibiotics or other antimicrobial medications outside of a hospital setting. This approach has allowed individuals to receive necessary therapy while avoiding prolonged hospital stays.

If you are considering this treatment option, read on to learn about what it is and whether it is right for you.

OPAT in a Nutshell

OPAT is a treatment option that enables patients to receive intravenous antimicrobial therapy outside of the traditional hospital environment. Candidates for OPAT generally fall into one of two categories: 

  • those who have completed an initial phase of antibiotic treatment in the hospital but require ongoing therapy, and 
  • those who can be directly admitted to OPAT without a hospital stay

What do I need to consider if I'm interested in OPAT?

The first step is to consult our OPAT team about whether you are suitable for the treatment. For starters, here are 3 key considerations.

1. Vascular Catheter

OPAT requires the placement of a vascular catheter, typically a peripherally inserted central catheter (PICC) or central venous catheter (CVC), to administer the intravenous medications. This catheter is inserted into a vein in the arm or chest and allows for easy and safe access for medication infusion.

If there is no sign of catheter infection, patients may use the same catheter for up to 3 to 6 months.

2. Infusion Pump or Daily Infusion

Our doctors will determine the mode of antibiotics delivery. It could be done via:

  • Daily infusion: this involves daily visits to OPAT clinic for about 30 minutes up to 3 hours depending on your type of antibiotics where the OPAT nurses will administer the antibiotics.
  • Pump infusion: the antibiotics will be infused into patients through elastomeric pumps which will need to be changed at home every 24-48 hours. One may continue daily activities at home and return to work without much inconvenience. The remaining pumps will need to be kept in a refrigerator at 2-8°C (avoid putting them in the freezer).

3. Transport and Caregiver

Outpatient therapy necessitates travel to a healthcare facility for antibiotics administration, regular blood tests monitoring and intravenous line dressing change. Patients must consider transport logistics and ensure they have reliable means of getting to their appointments. Additionally, it is important to have a caregiver or support system that can assist with transportation and monitoring of the OPAT regimen.

Risks Associated with OPAT

OPAT also comes with potential risks and complications. It is essential to be aware of these risks and take steps to minimize them. The risks are usually related to:

  • Infection being treated. 
  • Antibiotics administered. 
    • These may cause rash or other side effects. Your doctor may advise a change of antibiotics.
  • Infected vascular catheter 
When there are serious complications, one may need to be readmitted to the hospital.  

How to minimise the risks?

To minimize risks associated with OPAT, it is important to maintain open communication with your healthcare team, diligently follow the prescribed treatment plan, and be vigilant for any signs of complications.

Other steps include:

  • Prevent the vascular catheter from getting wet. 
  • Call OPAT clinic during office hours or head to the emergency department if you encounter fever, rash, pain, redness, swelling or discharges over your CVC/PICC exit site.

Frequently Asked Questions (FAQs)

Outpatient Parenteral Antimicrobial Therapy (OPAT) FAQs

Do I need to return to the hospital daily?

It depends on the type of antibiotics and mode of antibiotics delivery. You may need to visit the OPAT clinic either:
  • Once a day for 1-3 hours for IV infusion;
  • Once a day for intramuscular injection
  • Once a week for blood test and changing of the CVC/PICC dressing 

How much does OPAT cost?

The cost is subject to the type of antibiotics and duration of treatment. Our OPAT nurses will inform all patients about the estimated cost before treatment begins.

OPAT charges can be covered by MediSave. 

Where do I learn more about OPAT?

Click "Play" on the introductory video below which will give you a better idea of how OPAT is performed:

Otherwise, visit our clinic at Singapore General Hospital and speak to our nurses and specialist doctors about whether the treatment is suitable for you. 

Here are our details below: 

OPAT clinic at 17 Third Hospital Ave, Singapore 168752 
Diabetes & Metabolism Centre Level 4 

Contact Information
Tel: (65) 6326 6727
Fax: (65) 6324 1837

Opening hours
Monday to Friday from 8:00am-5:00pm
Saturday and Sunday from 8:00am-12.00PM for special cases only

What happens during OPAT?

A visit to the OPAT clinic for daily injection first begins with the administration of the antibiotics. 

Thereafter, the OPAT nurses will draw bloods to investigate the performance of the antibiotics. This will be done weekly or as when necessary. On the other hand, if your doctor has put you on PICC or CVC, a visit would entail collection of the antibiotic pumps and management of the vascular catheter device where needed.