P02 An outpatient home IV antibiotic therapy programme in a tertiary referral pulmonary infection centre - safety, cost-effectiveness, and service outcomes

Sep 29, 2026

Uploaded by Eliana

Retrospective audit evaluates a patient/carer-administered home IV antibiotic therapy (OPAT) programme for chronic and complex pulmonary infections in a tertiary referral centre. Outcomes assess safety, cost-effectiveness, and service delivery from 1 Jan to 31 Dec 2023, including pwCF and non-CF lung disease cohorts. Among 413 episodes, sputum cultures supported therapy in most courses; adverse events were predominantly non-severe, with no line-related bloodstream infections. The programme reduced inpatient bed-days by 5682 with £3.9M savings.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Objectives

Safety and cost-effectiveness evaluation

Service outcomes and optimization

Methods

Retrospective audit design and inclusion

Data collected

Cost-savings calculation

Results

Treatment episodes and cohort distribution

Treatment duration and microbiology

Adverse events and discontinuation

Conclusions

Posters range 2–32) . Sputum cultures were attempted in 91%(n=374) of courses, with at least one isolate in 263 specimens and no signiﬁcant growth in 110; only six cases lacked recent microbiology to guide therapy. Pseudomonas aeruginosa was the most frequent isolate. Mean CRP at start was 14 mg/L (SD 24; range 3–200), and at end 11 mg/L (SD 20; range 3–219), with a mean reduction of 4 mg/L. Seventy-three courses ended before 10 days: 25 due to side effects or allergy, 5 due to marked improvement, 1 at patient request, and 7 due to hospital admission. Reported adverse events included non-severe cutaneous (n= 10), ill-deﬁned/subjective (n=6), gastrointestinal (n=4), liver function derangements (n=3), hyponatraemia (n= 1), and ﬂuid overload (n=1) . No line-related bloodstream infections occurred. Two patients tested positive for Clostridioides difﬁcile, however, one of these was toxin-negative, and the other was positive 6 months after the course of home IV antibiotics. The programme saved 5682 inpatient bed-days, equating to £3·9M in cost savings (76% reduction) compared with inpatient care, exceeding published benchmarks (40%–56%) . Conclusions: Home IV antibiotic treatment for complex respiratory infections, self orcarer-administered in a tertiary ambulatory care setting is safe, highly costeffective, and patient-centred. Cost savings substantially exceed published estimates. Future improvements should focus on ways to improve antibiotic stewardship, including early response-guided treatment shortening. Abstract citation ID: dlaf239.006 P02 An outpatient home IV antibiotic therapy programme in a tertiary referral pulmonary infection centre: safety, cost-effectiveness, and service outcomes Milton James Micallef1,2, Novis Kola1, Lucy Carson1, on behalf of Royal Papworth Hospital, Uta Hill1 1Royal Papworth Hospital NHS Foundation Trust, Papworth Road, Cambridge Biomedical Campus, Cambridge, CB2 0AY, UK; 2UNSW Sydney, Prince of Wales Clinical School, Randwick, New South Wales 2031, Australia Objectives: To evaluate the safety, cost-effectiveness, and service outcomes of a patient/carer-administered home IV antibiotic therapy (OPAT) programme for patients with chronic and complex pulmonary infections, and to identify best practicesand areas for service optimization. Methods: A retrospective audit was conducted of all patients treated via our patient/carer-administered OPAT service between 1 January and 31 December 2023, excluding those who opted out via the NHS National Data Opt-out service (n=26 patients, 39 courses excluded). All eligible patients, including people with cystic ﬁbrosis (pwCF) and those with non-cystic ﬁbrosis-related lung disease (non-CF), were included. Data collected included demographics, patient cohort, patient experience with our model, mode of IV access (long line, peripherally inserted central catheter, totally implanted vascular access device), antibiotic regimen, duration of treatment, adverse events, reasons for early cessation, sputum microbiology, C-reactive protein (CRP) at start and end of therapy. Cost savings were calculated using NHS reference inpatient bed-day costs. Results: A total of 413 treatment episodes were delivered to 274 patients (74 pwCF courses, 339 non-CF courses). The mean treatment duration was 13·8 days (SD 4·4;

FAQs

What was the goal of the home IV antibiotic therapy programme (OPAT)?

The study aimed to evaluate safety, cost-effectiveness, and service outcomes for patient/carer-administered home IV therapy, and to identify best practices and opportunities to optimize the service.

How was the OPAT programme evaluated in the study?

A retrospective audit reviewed all patients treated through the patient/carer-administered OPAT service from 1 January to 31 December 2023, excluding those who opted out via the NHS National Data Opt-out service.

What safety and cost-effectiveness outcomes were reported?

The programme reported no line-related bloodstream infections and adverse events were largely non-severe. It saved 5682 inpatient bed-days, corresponding to about £3.9M in cost savings and a 76% reduction compared with inpatient care.

Sep 29, 2026

Uploaded by Eliana