Clinical and patient-reported outcomes of Self-administered Outpatient Parenteral Antimicrobial Treatment (S-OPAT): a scoping review

Clinical and patient-reported outcomes of Self-administered Outpatient Parenteral Antimicrobial Treatment (S-OPAT): a scoping review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Clinical and patient-reported outcomes of Self-administered Outpatient Parenteral Antimicrobial Treatment (S-OPAT): a scoping review Jolanda Maaskant, Tessa de Vries, Laura Volle, Faridi Jamaludin, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6390941/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 12 May, 2025 Read the published version in Infection → Version 1 posted 7 You are reading this latest preprint version Abstract Purpose This study aimed to provide a comprehensive overview of the existing literature on Self-administered Outpatient Parenteral Antimicrobial Therapy (S-OPAT), focusing on safety and clinical outcomes, factors influencing these outcomes, and the experiences of patients and caregivers. Methods We searched the databases MEDLINE, CINAHL, Embase and Cochrane library. Publications were included if they reported on the clinical outcomes, safety, and/or experiences of patients and caregivers with S-OPAT. Study selection and data extraction were performed independently by two reviewers. Quantitative and qualitative data were summarized in data charting forms. Results Forty-four studies were included: 41 primary studies, 2 systematic reviews and 1 clinical guideline. Clinical outcomes were reported in 17 and safety in 23 primary studies. Eleven studies compared S-OPAT to other OPAT delivery models. These studies showed that all models were generally comparable regarding clinical outcomes, but two studies reported an increased number of adverse events with S-OPAT. Nine studies, exploring a total of 7 potential risk factors, identified older age, comorbidities and Staphylococcus aureus infections as contributors to adverse events. The results of 14 studies on patient-centred outcomes showed that patients and caregivers considered S-OPAT a suitable alternative to other OPAT delivery models. Conclusion We conclude that S-OPAT is a viable model of care, demonstrating favourable clinical outcomes, although some safety concerns have been reported. The growing care demand now and in the future urges further development of S-OPAT care. Gaps of knowledge still exist, and we provide recommendations for future research. S-OPAT self-administration safety clinical outcome patient-reported outcome scoping review Figures Figure 1 Introduction Outpatient parenteral antimicrobial therapy (OPAT), as defined by the Infectious Diseases Society of America, is ‘the administration of at least two doses of parenteral microbial therapy on different days without intervening hospitalization' [ 1 ]. This approach allows patients who require parenteral antibiotic treatment to be discharged from the hospital, provided they are stable enough to continue their care at home. Since its inception in the 1970s, OPAT has been increasingly employed to facilitate medical treatment in a familiar environment, increase patient autonomy, reduce costs, increase hospital bed availability, and reduce the risk of nosocomial infections [ 2 , 3 ]. A recent systematic review shows that OPAT is a safe and effective alternative to inpatient treatment [ 4 ]. Self-administered OPAT (S-OPAT) is a variant of OPAT in which parenteral antimicrobial treatment is administered by patients themselves, family members, or other caregivers, typically in the home setting. The term was coined in 2007 to distinguish this model from OPAT administered by healthcare [ 5 ]. However, the concept dates back further, as the first clinical report on OPAT already describes self-administration of treatment [ 6 ]. The advantage of S-OPAT is that it does not require dedicated mobile healthcare professionals for administration visits. Ideally, S-OPAT reduces healthcare staffing demands and costs, provides patients with greater control over their schedules, and enables the extramural use of antimicrobials administered in multiple doses per day, all while maintaining safety and effectiveness of treatment [ 2 , 5 ]. A survey performed among experts from 28 European countries concluded that S-OPAT is offered in 10 countries but is considered standard practice only in Switzerland and the United Kingdom [ 7 ]. Wider use of S-OPAT may be hampered by uncertainty on its clinical outcomes and safety compared to other OPAT administration models. Moreover, there is a need for further understanding of which patients are best suited for S-OPAT, the factors that influence treatment outcomes, and the experiences of patients and their caregivers [ 8 ]. In this context, the aim of this scoping review is to provide a comprehensive overview of the existing literature on S-OPAT, focusing on clinical outcomes and safety of S-OPAT, factors influencing these outcomes, and the experiences of patients and caregivers. In addition, we aimed to identify gaps in knowledge and future directions of research. Methods We performed a scoping review guided by the Joanna Briggs Institute methodology for scoping reviews [ 9 ] and reported according to the PRISMA extension for scoping reviews recommendations (PRISMA-ScR) [ 10 ]. Search strategy. The search strategy was developed in consultation with a medical librarian of Amsterdam University Medical Centre (FJ). Search terms were based on the key components of S-OPAT: self-administration, outpatient setting, parenteral/intravenous administration, and antimicrobial agents. We searched the following online databases: MEDLINE, CINAHL, Embase and Cochrane library. As the term S-OPAT was first established in 2007, the search was limited to the period between 2007 and the search date (21 March 2024). We applied no restrictions based on language or geographical origin. The final search strategy is presented in Appendix A. Eligibility criteria Considered for inclusion were publications providing information on the clinical outcome and safety of parenteral antimicrobial treatment administered by patients or their caregivers in an outpatient setting, or on the experiences of patients and caregivers involved in S-OPAT administration. We excluded publications that studied different OPAT delivery models but did not report results on S-OPAT separately. Participants of interest were any patients, including children, undergoing S-OPAT. Caregivers were considered participants of interest only in the context of their experiences with aiding with or administering the antimicrobial treatment. Primary research studies (quantitative, qualitative, and mixed methods), quality improvement reports, (systematic) reviews and guidelines were eligible for inclusion. We excluded editorials, letters to the editor, publications reporting the results of the same study, case studies, and guidance documents. Study selection After removal of the duplicates, titles and abstracts were screened by two reviewers independently (LV, JMM). Disagreements were resolved by discussion and in consultation with a third reviewer (KS). In case of persistent uncertainty, a publication was passed onto the full text stage. All publications that were considered potentially relevant were screened full text by one reviewer (LV), with regular team discussions throughout the process. The reference lists of all included publications were hand-searched to seek for additional relevant publications. When full text was not available, corresponding authors were contacted. Rayyan Systems Inc. was used for managing the selection process. The literature selection process and results are visualized in a PRISMA flow chart. Data charting and synthesis of results A data extraction form was constructed and piloted on 5 randomly selected publications and refined throughout this process. Data of the remaining publications were extracted by two reviewers (JMM, TV) independently. We resolved disagreements by consensus and discussion with the research team. After several discussion rounds, all researchers agreed upon the final version of the charting tables. We extracted characteristics of the study, i.e. authors, year and country of publication, and study type. Furthermore, we collected data describing the population, the antimicrobial treatment, and the outcomes. The outcomes were divided into clinical outcomes (e.g. success and failure of the treatment) and safety (e.g. complications, adve r se events, hospitalizations, mortality) as defined in the publications. In addition, we extracted factors reported to impact the clinical outcomes and safety. Experiences of patients and caregivers were looked for both quantitatively and qualitatively. No quality assessment was executed, because scoping reviews are conducted to provide an overview of the existing evidence regardless of methodological quality or risk of bias [ 10 , 11 ]. We summarized findings of the included studies by the types of outcomes narratively as well as in tabular form. If publications report on different OPAT delivery models, we only considered the S-OPAT data. Qualitative data on the outcome of interest were summarized, and descriptive statistics were used to present the quantitative data. Results After deduplication, the literature search yielded 353 potentially relevant publications, 219 of which were selected for full-text screening. The full text of 5 publications could not be retrieved. We excluded 170 publications based on the full-text screening, resulting in 44 studies for final inclusion [ 1 , 5 , 8 , 12 – 52 ]. Cross-checking the reference lists did not yield new publications. The selection process is visualized in Fig. 1. Characteristics of the included studies The characteristics of the 44 included studies are presented in Table 1. Publications from 9 countries were included. Fifteen publications originated from the United States of America [ 1 , 12 , 13 , 18 , 23 , 26 – 31 , 35 , 36 , 38 , 51 ], 10 from the United Kingdom [ 5 , 8 , 15 – 17 , 20 , 21 , 25 , 49 , 50 ] and 8 from Spain [ 14 , 19 , 37 , 39 – 42 , 44 ]. Other publications originated from Germany [ 22 , 33 , 34 , 45 ], Australia [ 47 , 48 ], Switzerland [ 24 , 43 ], Ireland [ 32 ], Singapore [ 46 ], and the Kingdom of Saudi Arabia [ 52 ]. Two systematic reviews [ 8 , 14 ], one guideline [ 1 ], and 41 publications reporting original data were included [ 5 , 12 , 13 , 15 – 52 ]. In total we found 35 cohort studies; 22 were retrospective [ 5 , 12 , 15 – 20 , 23 , 25 , 26 , 32 – 34 , 36 , 38 , 42 , 44 , 47 , 48 , 50 , 51 ], 12 prospective [13, 21 , 22 , 24 , 27 , 35 , 37 , 39 , 40 , 45 , 46 , 52 ], and 1 study used a combination [ 41 ]. Eleven studies compared S-OPAT with OPAT [ 5 , 15 , 16 , 20 , 25 , 32 , 42 , 44 , 46 , 47 , 50 ], 1 study compared S-OPAT with oral antibiotic therapy [ 35 ], and 9 studies explored factors influencing the clinical or safety outcomes of S-OPAT [ 13 , 18 , 23 , 27 , 36 , 38 , 40 , 48 , 51 ]. Fourteen studies described the findings in a single cohort [ 12 , 17 , 19 , 21 , 22 , 24 , 26 , 33 , 34 , 37 , 39 , 41 , 45 , 52 ]. Other studies used qualitative study designs [ 28 – 30 , 49 ] or surveys [ 17 , 31 – 34 , 37 , 43 , 51 ]. Three publications reported results of a paediatric population [ 12 , 35 , 47 ]. Thirteen publications focused on specific patient groups, i.e. non-injecting drug users [ 13 ], uninsured patients [ 16 , 23 ], patients with periprosthetic joint infections [ 22 ], spinal infections [ 33 ], cranial infections [ 34 ], chronic respiratory diseases [ 14 , 37 , 39 , 42 ], musculoskeletal infections [ 5 , 51 ], and endocarditis [ 41 ]. Caregivers of adult patients participated in two studies [ 21 , 29 ], and caregivers of pediatric patients in one [ 35 ]. Table 1 Characteristics of included studies Aggregated publications Author, date Country Type of publication No of studies included Type of studies included Population Balaguer, 2015 Spain Systematic review 1 Randomized controlled trial Adults and children with cystic fibrosis receiving intravenous antimicrobial treatment at home or in hospital Mitchell, 2017 UK Systematic review Total 128 S-OPAT 66 All studies, except case reports, reporting on OPAT and S-OPAT Adult patients treated for any condition (and/or their caregivers), or practitioners involved in the delivery of OPAT Norris, 2018 USA Clinical guideline NA NA Adults and children treated for any condition Primary studies Study or publication Population Antimicrobial treatment Author, date Country Type Participants Sample size Indications 1 Antimicrobial agents 2 Duration Akar, 2014 USA Retrospective chart review Children, 53% with chronic underlying illnesses. Mean age 8.4 y. Patients 183 Episodes 210 Musculoskeletal, bloodstream, pulmonary and intra-abdominal infections Cefazolin, ceftriaxone, ceftazidim, clindamycin, ertapenem, vancomycin Mean 16 d. (range 2–53) Appa, 2020 USA Prospective cohort study Adult patients with and without non-injecting drug use. Median age 51 y. (IQR 40–60) Patients 72: - Drug users 35 - No drug users 37 Bacteremia, osteomyelitis, abscess/complex soft tissue infection NR NR Barr, 2012 UK Retrospective cohort study Adult patients. Mean age 55.1 y. (IQR 45.8–68.1) Episodes 854 NR NR Median 41 d. (range 25.8–65.5) Bhavan, 2015 UK Retrospective cohort study Uninsured patients. Range age 16 - ≥ 65 y. Patients 1168: - S-OPAT 944 - OPAT 224 Infections bone and joint, skin and soft tissue, CNS, intra-abdominal, genitourinary, pulmonary, ENT, and bacteremia NR Median 26 d. at home Bodycot, 2021 UK Retrospective cohort study Adult patients Patients 958 Episodes 1084 Diabetic foot, urinary tract, and prosthetic knee-joint infections, osteomyelitis NR NR Cox, 2007 USA Retrospective cohort study Adults patients. Total group mean age 58.8 y. (range 23–83). Group age ≥ 60 y. 68.9 y. (SD 8.9). Group age < 60 y. 50.6 y. (SD 8.1) Patients 205 Episodes 231: - Age ≥ 60 y. 107 courses - Age < 60 y. 124 courses Osteoarticular, skin and soft tissue infections, bacteremia Cefazolin, ceftriaxone, ertapenem, vancomycin, Group age ≥ 60 y. median 22 d. (range 2–107) Group age < 60 y. median 29.5 d. (range 4–450) Dubois-Silva, 2023 Spain Retrospective cohort study Adult patients. Episodes 31 NR Meropenem NR Durojaiye, 2019 UK Retrospective cohort study Adult patients Patients 105 NR NR NR Eaves, 2014 UK Prospective clinical evaluation Adult patients, mean age 52 y. (range 21–79). Caregivers, mean age 63 y. (range 50–80) Patients 29 Caregivers 9 Wide range, e.g. discitis, endocarditis, osteomyelitis and lung abscess NR Median 42 d. (range 28–168) Frieler, 2021 Germany Prospective cohort study Adults patients. Mean age 66 y. (SD 15) Patients 26 (23 with complete follow-up) Episodes 54 Periprosthetic joint infections and multidrug-resistant pathogens Meropenem, vancomycin Mean 66 d. (SD 26) Ganguly, 2023 USA Noninferiority retrospective cohort study Uninsured adults patients. Mean age 50 y. (SD 13) Patients 368: - Group Cefazolin 286 - Group Ceftriaxone 82 Methicillin-susceptible Staphylococcus aureus infection Cefazolin, ceftriaxone Mean 35 d. (SD 18) Gardiol, 2016 Switzerland Prospective cohort evaluation Adult patients. Patients 55 NR NR NR Hatcher, 2019 UK Retrospective analysis of prospectively collected data Adult patients. Episodes 1793: - S-OPAT 252 - OPAT 1541 NR NR NR Karimaghael, 2021 USA Retrospective cohort study Adult patients with an elastomeric continuous infusion pump. Mean age 49.3 y. (SD 14.9) Patients 91 Neurosyphylis, ocular/otosyphilis, osteomyelitis/septic arthritis Nafcillin, penicillin Mean 20.4 d. (SD 20.6) Keller, 2018 USA Prospective cohort study Adult patient, median age 55 y. (IQR 41–63) Patients 399 Bacteremia, abdominal infection, osteomyelitis, septic arthritis Ceftriaxone, penicillins, piperacillin-tazobactam, vancomycin Median 29 d. (IQR 15–44) Keller, 2019 USA Qualitative study Adult patients. Interviews mean age 55 y. (ST 11.5). Observations mean age 51.5 y. (SD 15.2) Patients 43 - Interviews 29 - Observations 14 NR NR NR Keller, 2020 (a) USA Qualitative study Adult patients and caregivers. Patients 7 Caregivers 3 NR NR NR Keller, 2020 (b) USA Qualitative study Adult patients. Interviews mean age 55.4 y. (SD 12.5). Observations mean age 52 y. (SD 14.1) Patients 60: - Interviews 40 - Observations 20 NR NR NR Keller, 2022 USA Survey Adult patients. Mean age 57.5 y. Patients 20 NR NR NR Kieran, 2009 Ireland Retrospective analysis of prospectively collected data Adult patients. Patients 56 Episodes 60: - S-OPAT 48 OPAT 12 NR NR NR Kilinc, 2023 (a) Germany Retrospective cohort study Adult patients. Median age 52 y. (range 27–85) Patients 52 Spinal infections, such as spondylodiscitis and spinal empyema Cefazolin, ceftriaxone, Fosfomycin, vancomycin, Mean 41.3 d. (SD 16.4) Kilinc, 2023 (b) Germany Retrospective cohort study Adult patients. Median age 49 y. (range 20–71) Patients 45 Cranial infections Cefazolin, ceftriaxone, fosfomycin, meropenem, vancomycin Mean 41.1 d. (SD 14) Krah, 2018 USA Prospective cohort study Children and their caregivers Patients and caregivers 89 Central nervous system, osteomyelitis and/or septic arthritis, endocarditis, pneumonia, intra-abdominal infection, musculoskeletal with hardware Cefazolin, ceftriaxone, ertapenem Antimicrobial use duration median 39 d. (IQR 24–95) Lee, 2015 USA Retrospective review Adult patients. Mean age 58 (SD 17) Patients 400 Osteoarticular infections, bacteremia, abscess Cefazolin, ceftriaxone, ertapenem, oxacillin NR Lopez-Cortes, 2019 Spain Prospective cohort study Adult patients. Median age 71 y. (IQR 56–80) Patients 67 Exacerbation of Non-Cystic Fibrosis Bronchiectasis Ceftazidime, piperacillin/tazobactam, combination including meropenem, tobramycin, Median 12 d. (IQR 9–13) Matthew, 2007 UK Retrospective cohort study Adult patients. S-OPAT mean age 46.2 y. OPAT mean age 60.9 y. Episodes 2482: - S-OPAT 473 - OPAT 2009 Musculoskeletal infections (both groups) Ceftriaxone, teicoplanin Mode 6 weeks both S-OPAT and OPAT Mohammadi, 2013 USA Retrospective chart review Adult patients. Mean age 63.2 (range 31–87) Patients 190 Osteomyelitis, urinary tract, skin and soft tissue, bloodstream, and prosthetic joint infection, endocarditis. Ceftriaxone, nafcillin, vancomycin Median 30 d. (range 5–56) Monton, 2013 Spain Prospective cohort study Adult patients. Mean age 64 (SD 17) Patients 50 Episodes 74 Exacerbation of a chronic respiratory disease NR Mean 19 d. (SD 13) Mujal, 2016 Spain Prospective cohort study Adult patients. Group < 65 y. mean age 47.7 y. (SD 13.3). Group 65–79 y. mean age 72.3 y. (SD 4.1). Group ≥ 80 y. mean age 84.9 y. (SD 3.7) Patients 420: - Group < 65 y. 139 - Group 65–79 y. 182 - Group ≥ 80 y. 99 Respiratory, urinary, intra-abdominal, osteoarticular, skin infections Ceftriaxone, cefepime/ceftazidime, ertapenem, meropenem, piperacillin/tazobactam, vancomycin/teicoplanin NR Pajaron, 2017 Spain Cohort study with retrospectively and prospectively collected data Adults patient. Mean age 61 (SD 16.5) Patients 54 Episodes 57 Infectious endocarditis Ampicillin, ceftriaxone, cloxacillin, daptomycin, linezolid, penicillin G, teicoplanin, vancomycin Mean 3.1 w. (SD 0.9) Ponce Gonzalez, 2017 Spain Retrospective cohort study Adults patients. Patients 174 Acute exacerbation of COPD Amikacin, cefepime, ceftazidim, ceftriaxone, ertapenem, levofloxacin, meropenem, piperacillin/ tazobactam NR Saillen, 2017 Switzerland Survey Adult patient. Mean age 56 y. (SD 15) Patients 71 Osteoarticular, urinary tract, endovascular, intra-abdominal, skin and soft-tissue infections, endocarditis NR Mean 19.2 d. (SD 16.6) Sanroma, 2018 Spain Retrospective study Adult patients. Patients 371 NR Ertapenem Median 9 d. (range 6–13) Schmidt-Hellerau, 2024 Germany Prospectively observational study Adult patients. Median age 56 y. (IQR 40–66) Patients 77 Joint and bone infections, vertebral osteomyelitis, periprosthetic joint infection, septic arthritis, bacteremia, endocarditis, neurosyphylis Ceftriaxone, flucloxacillin, Meropenem, penicillin, vancomycin Median 15 d. (IQR 11–26, range 5–127) Seetoh, 2013 Singapore Prospective cohort study Adult patients. Episodes 397 NR NR NR Sriskandarajah, 2020 Australia Retrospective review Pediatric patients. Mean age 9.13 (SD 5.12) Episodes 100: - S-OPAT 49 - OPAT 51 Cystic fibrosis, osteomyelitis, pneumonia, septic arthritis, bacteremia, primary ciliary dyskinesia Tobramycin in combination with ceftazidime or piperacillin/tazobactam Median 14.5 d. (IQR 14.5 -24.75). OPAT median 11 d. (IQR 8–14) Subedi, 2015 Australia Retrospective analysis of prospectively collected data Adult patients. Medina age 55 (range 16–90) Patients 144 Episodes 150 Osteomyelitis, septic arthritis, endocarditis, bacteremia, skin and soft-tissue, surgical site, central nervous system, and intra-abdominal infections Benzylpenicillin, cefazolin, ceftazidime, ceftriaxone, clavulanic acid, ertapenem, flucloxacillin, lincomycin, meropenem, teicoplatin ticarcillin-Vancomycin Median 22 d. (range 4–106) Twiddy, 2018 UK Qualitative study Adult patient. Patients 5 NR NR NR Underwood, 2019 UK Retrospective analysis of prospectively collected data Adult patients. Episodes 30 NR NR NR Yagnik, 2022 USA Retrospective chart review Adult patients. Mean age 49 y. (SD 13) Episodes 200: - Drip infusion method 95 - Prefilled syringe delivery method 105 Bone and joint infection Cefazolin, cefepime, ceftriaxone, daptomycin NR Zikri, 2021 SAU Prospective cohort study Adults patients. Mean age 53 y. (range 17–77) Patients 47 Urinary tract, diabetic foot, respiratory tract, intra-abdominal and cardiovascular infections Ceftriaxone, Imipenem, meropenem, piperacillin/tazobactam NR CNS: Central Nervous System; COPD: Chronic Obstructive Pulmonary Disease; ENT: Ear/Nose/Throat; IQR: interquartile range; NA: not applicable; NR: not reported (for the S-OPAT participants); PICC: peripherally inserted central catheter; SD: standard deviation; SAU: Kingdom of Saudi Arabia; TCVC: tunneled central venous catheter; UK: United Kingdom; USA: United States of America; y: years; d: days; w: weeks. 1 Most frequently reported indication; 2 Most frequently reported antimicrobial agents Aggregated publications of S-OPAT Our search yielded two systematic reviews [ 8 , 14 ] and one guideline [ 1 ]. The systematic review by Mitchell et al. included 128 studies that evaluated existing evidence on the efficacy, safety, acceptability, and cost-effectiveness of different OPAT delivery models. Studies that evaluated S-OPAT as a single model of delivery were few (16/128, 12.5%) and published before the inclusion period of our review [ 8 ]. The systematic review by Balaguer et al. included one randomized controlled trial evaluating S-OPAT versus hospital intravenous antibiotic treatment for cystic fibrosis [ 14 ]. This study originated from 1997 and was therefore excluded from our review. The 2018 IDSA guidelines strongly recommend patients to be allowed self-administration, based on low-quality evidence, but on vast clinical experience with S-OPAT [ 1 ]. Outcomes reported in the primary studies. Clinical and safety outcomes of S-OPAT are presented in Table 2. Clinical outcome We found 17 publications reporting on clinical outcomes [ 12 , 17 , 22 , 25 , 26 , 32 – 34 , 37 , 39 , 41 , 43 , 44 – 47 , 52 ], of which 5 studies evaluated the clinical outcome of S-OPAT in comparison with OPAT care delivered by healthcare professionals, either in specialized OPAT clinics [ 46 ], at the patients’ homes [ 32 , 42 , 44 ], or a combination [ 25 ]. Comparison of S-OPAT with OPAT delivered by healthcare professionals at the patients’ homes, e.g. community nurses, showed no differences in clinical outcome [ 25 , 32 , 42 , 44 ]. The study by Hatcher et al. also compared outcomes of S-OPAT patients with patients receiving care at specialized OPAT clinics. Their results showed that clinic-based OPAT was associated with an increased odds of OPAT success, defined as survival without readmission (OR 2.1, 95%CI 1.03–2.28, p = 0.02) [ 25 ]. However, Seetoh et al. reported no significant difference between S-OPAT and clinic-based OPAT on unplanned readmission or death [ 46 ]. Safety We found 23 publications reporting on safety [ 5 , 12 , 15 – 17 , 19 , 20 , 22 , 24 – 26 , 32 – 34 , 37 , 39 , 41 , 42 , 44 , 45 , 47 , 50 , 52 ]. Nine studies evaluated the safety of S-OPAT in comparison with OPAT care delivered by healthcare professionals, either in specialized OPAT clinics [ 15 , 20 , 50 ], at the patients’ homes [ 5 , 32 , 42 , 44 , 47 ], or a combination [ 16 ]. Bhavan et al. reported a significant difference between S-OPAT and a healthcare professional OPAT model on 30-days all cause readmission in favor of S-OPAT (16.7% versus 23.7%, adjusted HR 0.53, 95%CI 0.35–0.81, p = 0.003) [ 16 ]. No significant differences were found between S-OPAT and other OPAT delivery models on catheter events [ 15 , 32 , 42 ], adverse drug events [ 32 , 42 ], complications [ 5 ], infection-related complications [ 42 ], readmissions [ 5 , 20 , 32 , 44 ], and mortality [ 16 , 44 ]. Three publications evaluated S-OPAT as a potential risk factor for adverse safety outcomes [ 20 , 47 , 50 ]. S-OPAT was not associated with 30-days unplanned hospitalization [ 20 ]. However, S-OPAT was significantly associated with the risk for adverse events (adjusted OR 6.25, 95%CI 1.44–27.15) [ 47 ], and catheter-related adverse events (HR 4.15, 95%CI 1.7–9.1, p = 0.007) [ 50 ]. Table 2 Clinical outcomes and safety of S-OPAT Author, date Clinical outcomes Safety Definition Results Definitions Results Comparative studies Barr, 2012 NR NR - Line infection (local infection, bloodstream infection) - Other line events (chemical or mechanical phlebitis, leakage, extravasation, occlusion, non-electively removal) S-OPAT versus OPAT (corrected for confounders): - Line infection 11/532 (2%) versus 9/298 (2.9%), NS - Other line events 91/452 (16.8%) versus 34/273 (11.1%), NS Bhavan, 2015 NR NR - 30-days all cause readmission - 1-year all cause mortality S-OPAT versus OPAT (corrected for confounders): - Readmission 158/944 (16.7%), versus 53/224 (23.7%), HR 0.53, p = 0.003 - Mortality 51/944 (5.4%) versus 10/244 (4.5%), NS Durojaiye, 2019 NR NR 30-days unplanned hospitalization In a multivariable model, S-OPAT was not significantly associated with 30-days unplanned hospitalization, NS Hatcher, 2019 S-OPAT success (no readmission due to infection worsening or due to adverse event, and no mortality by any cause during OPAT) S-OPAT success 233/252 (92.5%) Multivariable analyses showed - OPAT-clinic versus S-OPAT: OR 2.1, 95%CI 1.03–2.28, p = 0.02. - OPAT-community nurse versus S-OPAT, NS S-OPAT-related adverse events (drug-related, line-related) S-OPAT-related adverse events 16/252 (6.3%) 1 Kieran, 2009 Clinical cure 52/56 patients (93%) Differences between S-OPAT and OPAT, NS No further information provided. - Readmissions related to S-OPAT - AEs (line-related complications, drug-rel.ated adverse events - Readmissions: 5/60 (8%) - Line-related complications 5/60 (8%) - Drug-related adverse events 4/60 (7%) Differences between S-OPAT and OPAT, NS. No further information provided. Matthews, 2007 NR NR - Complication rate (side effects or intolerance of drugs, complications related to vascular access device) - Readmissions S-OPAT versus OPAT - Complication rate: 112/473 (24%) versus 353/1536 (23%), NS - Readmissions 50/473 (10.5%) versus 193/1536 (10.5%), NS Ponce Gonzalez, 2017 Effective treatment (absence of medical complications, absence of signs of acute disease, no ER visits, no readmissions, return to basal clinical situation) 93.4% Univariable analysis showed no differences between S-OPAT and OPAT - Adverse drug events - Catheter-related complications - Infection-related complications - Adverse drug events: 2.3% - Catheter-related complications: 2.7% - Infection-related complications: 5.7% Univariable analysis showed no differences between S-OPAT and OPAT Sanroma, 2018 Cure or improvement (resolution or partial resolution of symptoms) Multivariable analysis showed a non-significant association of S-OPAT with risk of treatment failure/relapse compared to OPAT - S-OPAT related readmissions - Death - Readmissions: 15/371 (4%) - Death: 13/371 (3.5%) Multivariable analysis showed a non-significant association of S-OPAT with safety outcomes compared to OPAT Seetoh, 2013 Clinical deterioration (worsened co-morbidity or worsened infectious disease for which OPAT was initiated, leading to unplanned re-admission or death) 9.6% Multivariable analysis showed no differences between S-OPAT and OPAT, NS - NR - NR Sriskandarajah, 2020 Completion of treatment as prescribed by pediatrician S-OPAT: 86/100 (86%) 1 - Unplanned readmission - AEs related to vascular access device - AEs related to infusion device - AEs related to antimicrobials - Readmission: 8/100 (8%) - AEs vascular access device: 16/100 (16%) - AEs infusion device: 4/100 (4%) - AEs antimicrobials: 0 Adjusted for covariates, S-OPAT was significantly associated with adverse events versus OPAT: OR 6.25, 95%CI 1.44-27,15 Underwood, 2019 NR NR Catheter-related adverse events - Adverse events: 8 (27%) or 12 (95%CI 6.0-23.9)/1000 catheter-days Adjusted Poison regression analysis showed S-OPAT was associated with a higher rate of catheter-related adverse events compared OPAT: HR 4.15, 95%CI 1.7–9.1, p = 0.007 Descriptive studies Akar, 2014 Antibiotic – organism mismatch (antibiotic resistant against the isolated organism, use of an antibiotic with a too broad or too small spectrum) 22/210 (10.5%) - Mechanical complication (dislodgement, displacement, thrombosis, damage to the catheter) - Antibiotic toxicity (neutropenia, hepatitis, colitis, rash) - Catheter-associated bloodstream infection - S-OPAT related ED visits or hospitalisations - Mechanical complications: 21/210 (10%) - Antibiotic toxicity: 26/210 (12.4%) - Catheter-associated bloodstream infections: 3/210 (2.6%) - ED visits or hospitalisations: 20/210 (9.5%) Bodycot, 2021 - Infection improved or cured. - S-OPAT process successfull or partially successful - Infection improved or cured: range 84.6% − 92 − 8% - S-OPAT (partially) successful: range 75%- 91.4% Serious vascular access device events (thrombus, catheter-related bloodstream infection) - Thrombus: 11/1084 (1%) - Catheter-related bloodstream infection: 2/1084 (0.2%) Dubois-Silva, 2023 NR NR - Catheter-related bloodstream infection - Readmission due to vascular access complication - Catheter-related bloodstream infection: 0 - Readmission: 0 Frieler, 2021 Successful treatment (infection eradication, no subsequent surgical intervention after revision surgery, no infection-related mortality) 21/23 (91%) - Adverse drug reactions - Catheter-related complications - Adverse drug reactions: 1/26 (2%) - Catheter-related complications 5/54 (9%) Gardiol, 2016 NR NR - Catheter-related bloodstream infection (positive blood culture). - OPAT-related readmission - Mortality - Catheter-related bloodstream infection 1/55 (2%) - OPAT-related readmission 2/55 (4%) - Mortality 0 Karimaghael, 2021 Treatment completion Cure from infection Treatment completion 83/91 (92.2%) Cure from infection 85/91 (93.4%) - 30-days readmission related to S-OPAT - 30-days ED visits related to S-OPAT - ED visits during and related to S-OPAT - Central line-associated issues - Antibiotics-related side effects - 30-days readmission 1/91 (1.1%) - 30-days ED visits 15/91 (16.5%) - ED visits during S-OPAT 15/91 (16.5%) - Central line-associated issues 13/91 (14.3%) - Antibiotics-related side effects 6/91 (6.6%) Kilinc, 2023 (a) Treatment failure 1 (2%) - Adverse effects or complications regarding laboratory parameters - PICC line complications - Readmission - Adverse effects or complications 0 - PICC line complications 0 - Readmission 1/52 (2%) Kilinc, 2023 (b) Treatment failure 3/45 (6.7%) - Readmission - Readmission 5/45 (11.1%) Lopez-Cortes, 2019 Resolution of the exacerbation (resolution of fever, resolution or reduction of purulent secretions, improvement of dyspnea, normalization of acute-phase reactants, and improvement of oxygen saturation levels) 63/67 (94%) - Readmission - Mortality - Nephrotoxicity - Catheter-associated bacteremia - Readmission: 4/67 (6%) - Mortality: 1 (2%) - Nephrotoxicity: 2 (3%) - Catheter-associated bacteremia: 0 Monton, 2013 Satisfactory clinical outcome 44/50 (87%) - Readmission during S-OPAT - Complications vascular access device - Readmissions: 6/50 (13%) - Complications:(minor): 15/50 (30%) Pajaron, 2017 Relapse of the infectious endocarditis 3 patients (5.2%) - Mortality - Complications resolved home - Unexpected readmissions - Mortality: 0 - Complications: 11/57 (19.2%) - Readmissions: 6/57 (10.5%) Schmidt-Hellerau, 2024 Curation or switch to oral antibiotic treatment 70/74 (95%) - Missed administrations more than 1 - All-cause readmissions - S-OPAT related readmission - Severe catheter-related AEs (CTCAE grade 3 and 4) - Missed administrations: 4/77 (5%) - All-cause readmissions: 16/77 (21%) - S-OPAT related readmission: 1/77 (1%) - Catheter-related AEs: 4/77 (5%) Zikri, 2021 Relaps of infection 6/47 (12.8%) - ED visits S-OPAT related - Readmissions S-OPAT related - Mortality - ED visits: 42/47 (89%) - Readmissions: 4/47 (8.5%) - Mortality: 0 AE: Adverse Event; CTCAE: Common Terminology for Adverse Events; ED: Emergency Department; HR: Hazard Ratio; OR: Odds Ratio; NR: not reported; NS: not statistically significant; 95%CI: 95% confidence interval; aIRR: adjusted incidence rate ratio 1 Results only descriptively reported. Factors impacting S-OPAT clinical outcome and safety A summary of the factors impacting S-OPAT clinical outcome and safety as reported in the included studies is presented in Table 3. Seven potential risk factors were studied in 9 studies: age [ 18 , 40 ], drug use [ 13 ], comorbidity [ 38 , 48 ], microbiological diagnosis [ 27 ], antimicrobial agent [ 23 , 27 , 36 ], catheter type [ 27 ], and delivery method [ 51 ]. Patients with two or more comorbidities had an increased risk of treatment failure [ 48 ], and diabetes resulted in an increased risk of relapse at 90 days post treatment [ 38 ]. Staphylococcus aureus infections were associated with an increased rate of catheter complications [ 27 ]. Older age increased the risk of nephrotoxicity [ 18 ], and readmission rates due to worsening of underlying diseases [ 40 ]. Some studies looked at individual antimicrobial agents in detail and found that cefazolin, vancomycin and daptomycin were associated with more catheter complications [ 23 , 27 ]. Lee et al. reported that antibiotic switches for adverse events were more frequent with oxacillin use [ 36 ]. Midline catheters were associated with an increased rate of catheter complications [ 27 ]. However, drip infusion or prefilled syringe delivery methods did not influence safety [ 51 ]. Table 3 Factors impacting S-OPAT clinical outcome and safety Factor Author, date Clinical outcomes Safety Definition Results Definitions Results Age Cox, 2007 Failure of treatment - Group age ≥ 60 y. versus group age < 60 y.: 9 (8%) versus 7 (6%), NS - Allergic reactions (rash, urticaria, anaphylaxis), nephrotoxicity, leucopenia, neutropenia, thrombocytopenia, eosinophilia - Venous access device complications (deep venous thrombosis, phlebitis, accidental removal of device, leaking, local infection and device-related bloodstream infection) - Hospital readmission - Urgent care visit related to S-OPAT Results/1000 home iv days, group age ≥ 60 y. versus group age < 60 y. - Nephrotoxicity: 3.03 versus 0.46, p = 0.02 - Urgent visits: 31.4 versus 14.3, p < 0.001 - Other outcomes, NS Mujal, 2016 Inadequate control of infection leading to antibiotic switch, readmissions Group < 60 y. versus Group 65–79 y. versus Group ≥ 80 y.: 29 (21%) versus 17 (9%) versus 18 (18%), NS - Adverse drug events - Catheter-related complications - Readmission < 30 days after discharge all cause - Readmission due to worsening of underlying diseases Group < 60 y. versus Group 65–79 y. versus Group ≥ 80 y. (corrected for confounders): - Adverse drug events: 7 (5%) versus 5 (2.7%) versus 3 (3%), NS - Catheter-related complications: 22 (15.8%) versus 32 (17.6%) versus 20 (20.2%), NS - Readmission < 30 days after discharge all cause: 27 (19.4%) versus 47 (25.8%) versus 27 (27.3%), NS - Readmission due to worsening of underlying diseases: 15 (10.8%) versus 38 (20.9%) versus 19 (19.2%), p = 0.05 Comorbidity Mohammadi, 2013 Overall clinical cure at end of treatment and 90-days post S-OPAT At end of treatment 148 (78%) 90-days post S-OPAT 110 (58%) After corrected for infection type, patients with diabetes had an increased risk of relapse at 90 days post S-OPAT: OR 1.76, 95%CI 1.57–196, p = 0.03 - AEs (neutropenia, diarrhea, rash, nephrotoxicity) - Complications related to vascular access device - Readmissions - ED visits - AEs: 12 (6.3%) - Vascular access device complications: 5 (2.6%) - Readmissions 3 (1.6%) - ED visits 2 (1.1%) Subedi, 2015 Treatment success (cure or major improvement, decrease in C-reactive protein, no relapse within 28 days after end of treatment) 93% Multivariate analysis showed patients with 2 or more comorbidities had an increased risk of treatment failure: OR 2.15, 95%CI 1.28–3.65, p = 0.004 - Drug-related complications (e.g. rash, hepatitis, gastrointestinal symptoms) - Line-related complications (line infection, thrombosis, leakage, accidental removal) - Readmissions - Drug-related: 11 (7%) - Line-related: 5 (3%) or 1.4/1000 catheter-days - Readmissions 9 (6%) Drug use Appa, 2020 Treatment completion Drug use versus no drug use: 91% versus 89%, NS - Hospital readmissions (30-days and 90-days) Drug use versus no drug use: - 30-days 3 versus 0, NS - 90-days 3 versus 2, NS Micro-biological diagnosis Keller, 2018 NR NR - Catheter complications (occlusion, thrombosis, extravasation, phlebitis) - Patients: 43 (12.7%) - 2.62/1000 OPAT days Factor associated with catheter complications: - Staphylococcus aureus infection (aIRR 2.13, 95%CI 1.09–4.19) Antimicrobial agent Ganguly, 2023 Treatment failure (repeat positive blood culture or retreatment within 6 months Cefazolin versus Ceftriaxone: 10 (4%) versus 2 (2%), NS - 30-days all-cause readmission rate - Central line-associated bloodstream infection Cefazolin versus Ceftriaxone: - Readmission rate 62 (22%) versus 17 (21%), NS - Central line-associated bloodstream infection 31 (11%) versus 2 (2%), p = 0.02 Keller, 2018 NR NR - Catheter complications (occlusion, thrombosis, extravasation, phlebitis) Associated with catheter complications: - Daptomycin (aIRR 4.45, 95%CI 1.02–19.41) - Vancomycin (aIRR 2.32, 95%CI 1.20–4.46) Lee, 2015 Clinical cure (resolution of signs and symptoms of infection and discontinuation of antibiotic therapy) Total 287 (72%) After correction for confounding: oxacillin showed a lower treatment success rate (HR 0.53, 95%CI 0.39–0.74) compared to ertapenem - Adverse drug reaction (diarrhea, fever, transaminitis, neutropenia, rash, acute renal injury) - Outpatient antibiotic switch - Readmissions within 30 days - Adverse drug reaction: 47 (11.6%) - Outpatient antibiotic switch: 50 (12.5%) - Readmissions: 67 (16.8%) After correction for confounding: oxacillin showed higher antibiotic switches due to adverse drug reactions or treatment failure (HR 5.06, 95%CI 1.74–14.75) compared to ertapenem. Catheter type Keller, 2018 NR NR - Catheter complications (occlusion, thrombosis, extravasation, phlebitis) - Patients: 43 (12.7%) - 2.62/1000 OPAT days Factor associated with catheter complications: - Midlines (aIRR 9.44, 95%CI 1.12–41.97) Delivery method Yagnik, 2022 NR NR - All cause 30-days readmissions - All cause 1-year readmissions - ED visits within 30 days - ED visits within 1 year - Mortality - 30-days readmissions: 21 (11%) - 1-year readmissions: 66 (33%) - ED visits 30 days: 46 (23%) - ED visits 1 year: 87 (44%) - Mortality: 11 (5%) There were no significant differences between the drip infusion and prefilled syringe delivery method. AE: Adverse Event; ED: Emergency Department; HR: Hazard Ratio; OR: Odds Ratio; NS: not statistically significant; 95%CI: 95% confidence interval; aIRR: adjusted incidence rate ratio Patient-centred outcomes A summary of the patients-centred outcomes is presented in Table 4. We found 14 publications reporting on patient-centered outcomes [ 17 , 21 , 28 – 35 , 37 , 43 , 49 , 51 ]. Seven studies explored patient-centred outcomes as secondary research objectives [ 17 , 32 – 35 , 37 , 51 ]. S-OPAT compared to OPAT showed more favorable outcomes for S-OPAT [ 43 ]. S-OPAT compared to oral antibiotics showed better patient-centred outcomes for oral antibiotics [ 35 ]. Over 90% of the participants preferred antibiotic treatment at home rather than in hospital [ 17 , 32 , 37 ], and satisfaction with S-OPAT was high [ 31 – 34 , 43 , 51 ]. At discharge and during the S-OPAT period patients and caregivers were comfortable with S-OPAT [ 31 , 35 ], and the burden for caregivers of pediatric patients seemed acceptable [ 35 ]. Two studies report high levels of competency of patients and caregivers after S-OPAT training [ 21 , 51 ]. Besides the positive results, barriers with S-OPAT, such as restricted mobility and infection prevention, are reported as well [ 28 – 30 ]. Table 4 Patients- and caregivers-centred outcomes Author, date Participants Sample size Data collection Results Comparative studies Krah, 2018 Pediatric patients and their caregivers 89 - Self-constructed survey exploring comfort with the S-OPAT process and burden of administration (5-point Likert scale) - Family impact module Paediatric Quality of Life Inventory Comparison between oral treatment versus S-OPAT: - Comfort with the treatment at discharge: mean 2.87 (SD 1.51) versus 2.09 (SD 1.46), p < 0.001 - Comfort with the treatment at follow-up: mean 3.02 (SD 1.59) versus 2.82 (SD 1.61), NS - Burden of drug administration caregiver: mean 0.64 (SD 0.84) versus 1.30 (SD 1.11), p < 0.001 - Burden of drug administration patient: mean 1.04 (SD 1.15) versus 1.38 (SD 1.14), NS - Burden laboratory tests: mean 1.87 (SD 1.31) versus 1.04 (SD 1.17), p < 0.001 After correction for baseline differences, QoL in the S-OPAT group was significantly lower than in the oral antibiotic group: difference 8.3 points, p < 0.001 Saillen, 2017 Adult patients 71 Survey - S-OPAT patients scored significantly better (after adjustment for age, sex and treatment duration) on 6/17 questions, compared to OPAT patients - Overall satisfaction was statistically higher in S-OPAT patients compared to OPAT patients: 96% versus 80% (OR 5.0, 95%CI 1.19-20.0) Descriptive studies Bodycot, 2020 Adult patients 105 Self-constructed questionnaire Preference for AB treatment at home: 29/32 (90.6%) Eaves, 2014 Adult patients and caregivers Patients 29 Caregivers 9 Reassessment of competence by specialist nurse. Median interval between completion of initial training and reassessment: 35 d. (range 12–118) - Fully competent: 35/38 (92%) - Patient made a mistake with immediate correction: 2/38 (5%) - Patient made a mistake and continued with the procedure: 1/38 (3%) Keller, 2022 Adult patients 20 Survey at least 2 weeks after discharge - Comfortable infusing medication at discharge: 18/20 (90%) - Comfortable infusing medication 2 weeks after discharge: 20/20 (100%) - Comfortable with bathing with the IV catheter: 16/20 (80%) - Satisfaction with the training: 19/20 (95%) - Satisfaction with managing the IV catheter at home: 20/20 (100%) Kieran, 2009 Adult patients 12 Standardized telephone survey - Preference for AB treatment at home 12/12 (100%) - Satisfaction with the service and the instructions 12/12 (100%) Kilinc, 2023 (a) Adult patients 52 Self-constructed survey - Satisfaction with S-OPAT: 51/52 (98.1%) - No problem managing S-OPAT at home: 43/52 (82.7%) - Ability to carry out tasks at home: 35/52 (67.3%) - Ability to return to work: 16/52 (30.8%) - Self-perceived good health: 48/52 (92.3%) Kilinc, 2023 (b) Adult patients 33 Self-constructed survey - Satisfaction with S-OPAT: 28/33 (84.8%) - Ability to carry out tasks at home: 19/33 (57.6%) Lopez-Cortes, 2019 Adult patients 67 Survey - Preference for AB treatment at home: 66/67 (99%) - Significant improvement in quality of life: 39/45 (86.7%) Yagnik, 2022 Adult patients Competency 200 Survey 22 Competency assessment by teach-back method Satisfaction survey - Competency: 82% achieved acceptable level in ≤ 3 attemps - Satisfaction survey: 96% of participating patients chose the syringe method over the IV drip Qualitative studies Keller, 2019 Adult patients Interviews 29 Observations 14 Semi-structured interviews. Contextual inquiry tools for the observations Hazards related to physical attributes in patients’ home environments: - Unclear how to bath with catheter - Pets shed fur, create waste and tug on catheter - Extremes in temperature (warm and cold) - Household clutter, e.g. patients cannot access certain parts of the home - Indoor soil and food, e.g. physical state makes it difficult to perform household tasks - Outdoor work: exposed to soil or dirt - Travel, e.g. patient must carry supplies and perform tasks outside of the home Keller, 2020 (a) Adult patients and caregivers Patients 7 Caregivers 3 Focus group discussions Barriers most frequently mentioned: - Healthcare professionals may not always with each other about the patient's care - Instruction is rushed - Uncertainty how to bath with a catheter - Patients and caregivers must devote a lot of time for S-OPAT tasks - The catheter gets caught as the patient moves around the house Keller, 2020 (b) Adult patients Interviews 40 Observations 20 Semi-structured interviews Contextual inquiry tools for the observations - Patients appreciate visual cognitive aids to remember (sub)tasks - Patients struggle to understand instructions - Patients are uncertain about several instructions, e.g. hand washing, the temperature of the medication - Patients struggle to detect incidents, and do not always respond to alerts Twiddy, 2018 Adult patients Patients 5 Semi-structured interviews - Multiple treatments each day left the patients with little time to fit anything else into the day - Maintaining aseptic technique, correct storage of medication and administering the drugs became routine for patients, but all were aware of the consequences of any lapse of judgement. Reminders by nurses were appreciated - Formal training and ongoing support by nurses were considered essential and enabled them to be fully involved in decisions about their care Discussion This scoping review aimed to give a comprehensive overview of publications reporting on the clinical outcomes and safety of S-OPAT, factors impacting these outcomes, and experiences of patients and caregivers with S-OPAT. After systematically searching the literature of the past 17 years, a total of 44 studies were included in this review. Clinical outcomes were reported in 17 and safety in 23 publications. Many publications were descriptive and reported on the evaluation of S-OPAT care in a single cohort. Eleven studies compared S-OPAT to other OPAT delivery models. These studies showed that clinical outcomes were generally comparable. Two studies found increased adverse events with S-OPAT, while the majority reported no safety concerns. Seven potential risk factors were explored in 9 studies: age, drug use, comorbidity, microbiological diagnosis, antimicrobial agent, catheter type, and delivery method. Risk factors for adverse events included older age, comorbidities and staphylococcus aureus infection. Fourteen studies reported on patient-centred outcomes and showed that patients and caregivers considered S-OPAT a suitable alternative for other OPAT delivery models. Healthcare systems will face substantial challenges in the coming decades. The aging population and the expected increase in chronic and acute diseases will result in a growing care demand. To ensure the availability, quality and affordability of care, efforts will need to be made to reduce unnecessary hospital stays and to increase the reliance on informal care. It is expected that patients will become increasingly dependent on family support [ 53 ]. This development also affects OPAT care, highlighting the urgent need for the implementation of an S-OPAT pathway. The studies in our review suggest that S-OPAT is an acceptable healthcare model for suitable patients. As safety is the main concern, healthcare professionals should anticipate preparing patients and family members during admission for the period after discharge to guarantee safety and optimal clinical outcome [ 54 ]. We identified a substantial degree of heterogeneity in the included studies. We observed substantial variation in patient populations, infectious disease diagnoses, and treatment characteristics (e.g., choice of antimicrobial agents or catheter type). Also, the varying comparators used in the comparative studies of S-OPAT makes it difficult to draw overarching conclusions. For example, OPAT care might be delivered by a community nurse at the patients’ homes, or within a specialized clinic or infusion centre, where patients attend an OPAT facility daily [ 55 ]. Moreover, the definitions of clinical outcome and safety differed across studies. For example, clinical outcome was reported as treatment success, cure, improvement or deterioration, and safety was recorded as drug-related adverse events, catheter complications, readmissions or mortality. These inconsistencies in outcome reporting make it impossible to make meaningful comparisons between studies, thereby hindering the ability to reach firm conclusions as previously noted [ 8 , 56 , 57 ]. To overcome this problem, the development of a core outcome set (COS) for research on OPAT delivery models might contribute to more consistency, making it easier for study results to be compared and combined as appropriate [ 58 ], and implemented [ 59 ]. This scoping review could be the first step, but obviously more work needs to be done, i.e. patient and caregiver consultation to identify the outcomes they consider relevant, and a Delphi study to reach consensus among experts. The previously developed set of quality indicators to assess and improve the quality of OPAT care may be helpful to move forward in this field [ 60 ]. Careful patient selection is considered crucial to guarantee a successful S-OPAT clinical pathway [ 1 ]. Selection criteria for OPAT are well described [ 61 ], but additional criteria are needed for S-OPAT. As self-administration is the key difference compared to OPAT delivery models, the additional criteria should focus on training and self-management skills, compliance of patients, the role of caregivers, and the safety and suitability of the home environment. The included studies in this review describing risk factors for adverse events during S-OPAT, did not describe these factors specifically related to S-OPAT. Previous studies have found positive associations between patients’ and caregivers’ experiences and clinical outcome and safety among a wide range of health conditions [ 62 , 63 ]. However, we found that only few of the clinical studies included in this review described patient-centred outcomes of S-OPAT. The experiences of caregivers were explored even less. Furthermore, constructs explored varied (e.g., satisfaction, comfort, experiences, self-efficacy) and were mainly measured with self-constructed questionnaires. As one of the main reasons to initiated S-OPAT is to improve the quality of life for both patients and caregivers [ 64 ], this outcome measure deserves additional attention. Validated tools are available, such as EQ-5D-5L [ 65 ] and CarerQoL-7D [ 66 ]. Also, confidence in managing health issues, and experienced burden are considered important outcome measures with the increasing involvement of patients and families in healthcare [ 62 ]. Again, these outcomes can be assessed using validated tools, such as the Health Confidence Score (HCS) [ 67 ], and the Caregiver Strain Index plus (CSI+) [ 68 ]. In addition, qualitative studies are valuable to obtain more in-depth information. Measuring patient reported outcome measures should be integrated in the S-OPAT pathway to provide optimal support for both patients and caregivers [ 69 ]. This scoping review has strengths and limitations. Firstly, we followed the preferred methodology of executing and reporting a scoping review and retrieved relevant articles using 4 distinct databases: MEDLINE, CINAHL, Embase and Cochrane library. Secondly, we studied nearly all studies full text as OPAT and S-OPAT are terms often used interchangeable. However, we limited the search to the past 17 years which may have resulted in missing publications published before that timeframe. However, older publications are less representative of the current state of S-OPAT literature, which we aimed to describe. In addition, we did not report on the level of evidence of the included studies. Performing critical appraisal was beyond the aim of this scoping review and is not required in the JBI methodology for scoping reviews. This means that this review provides a description of relevant publications to inform clinical practice on S-OPAT and does not attempt to draw conclusions based on their results. Besides the above-mentioned directions for future research, the role of artificial intelligence should be explored as an innovative approach to predict clinical outcome and safety for OPAT patients in different delivery models [ 70 ]. Another important research topic is the ecological footprint that comes with antimicrobial treatment and the different delivery models. It is widely recognized that healthcare has a large climate impact [ 71 ]. Based on the gaps of knowledge, we started research projects to investigate factors that contribute to successful S-OPAT care, experiences of patients and their caregivers, as well as the ecological footprint of different OPAT models. Conclusion This scoping review identified studies on S-OPAT with considerable variation in outcome measures, and a notable lack of research on patients and caregivers experiences. The growing care demand now and in the future urges further development of S-OPAT care. Recommendations for future research are formulated. Attention should be paid to robust study methodology and reporting, promoting homogeneity in outcome measures. Declarations Author Contribution JM: Conceptualisation, Methodology, Data collection, Synthesis, Writing - original draftTS: Methodology, Data collection, Synthesis, Writing - review and editingLV: Methodology, Data collection,FvE: Methodology, Data collectionSG: Conceptualisation, Writing - review and editingKS: Conceptualisation, Methodology, Synthesis, Writing - review and editing References Norris AH, Shrestha NK, Allison GM, Keller SC, Bhavan KP, Zurlo JJ, et al. 2018 Infectious Diseases Society of America Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy. Clin Infect Dis. 2019;68(1):1–4. https://doi:10.1093/cid/ciy867 . Bellamy R. Outpatient parenteral antimicrobial therapy. Br J Hosp Med (Lond). 2018;79(1):12–7. 10.12968/hmed.2018.79.1.12 . https:// . Williams DN, Baker CA, Kind AC, Sannes MR. The history and evolution of outpatient parenteral antibiotic therapy (OPAT). Int J Antimicrob Agents. 2015;46(3):307–12. https://doi.org/10.1016/j.ijantimicag.2015.07.001 . Mohammed SA, Roberts JA, Cotta MO, Rogers B, Pollard J, Assefa GM, et al. Safety and efficacy of outpatient parenteral antimicrobial therapy: A systematic review and meta-analysis of randomized clinical trials. Int J Antimicrob Agents. 2024;64(2):107263. https://doi:10.1016/j.ijantimicag.2024.107263 . Matthews PC, Conlon CP, Berendt AR, Kayley J, Jefferies L, Atkins BL, et al. Outpatient parenteral antimicrobial therapy (OPAT): is it safe for selected patients to self-administer at home? A retrospective analysis of a large cohort over 13 years. J Antimicrob Chemother. 2007;60(2):356–62. https://doi:10.1093/jac/dkm210 . Antoniskis A, Anderson BC, Van Volkinburg EJ, Jackson JM, Gilbert DN. Feasibility of outpatient self-administration of parenteral antibiotics. West J Med. 1978;128(3):203–6. Emilie C, de Nocker P, Saïdani N, Gilchrist M, Seaton RA, Patel S, ESGAP-BSAC OPAT Survey Working Group, et al. Survey of delivery of parenteral antimicrobials in non-inpatient settings across Europe. Int J Antimicrob Agents. 2022;59(4):106559. https://doi:10.1016/j.ijantimicag.2022.106559 . Mitchell ED, Czoski Murray C, Meads D, Minton J, Wright J, Twiddy M. Clinical and cost-effectiveness, safety and acceptability of c ommunity i ntra v enous a ntibiotic s ervice models: CIVAS systematic review. BMJ Open. 2017;7(4):e013560. https://doi:10.1136/bmjopen-2016-013560 . Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis. JBI; 2024. Available from: https://synthesismanual.jbi.global . Assessed: September 2024. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–73. https://doi:10.7326/M18-0850 . Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020;18(10):2119–26. https://doi:10.11124/JBIES-20-00167 . Akar A, Singh N, Hyun DY. Appropriateness and safety of outpatient parenteral antimicrobial therapy in children: opportunities for pediatric antimicrobial stewardship. Clin Pediatr (Phila). 2014;53(10):1000–3. https://doi:10.1177/0009922813507999 . Appa A, Marquez C, Jain V. Home-Based Outpatient Parenteral Antibiotic Therapy at an Urban Safety Net Hospital: Comparing Outcomes in Persons with and Without Noninjection Drug Use. Open Forum Infect Dis. 2020;7(5):ofaa162. https://doi:10.1093/ofid/ofaa162 . Balaguer A, González de Dios J. Home versus hospital intravenous antibiotic therapy for cystic fibrosis. Cochrane Database Syst Rev. 2015;2015(12):CD001917. https://doi:10.1002/14651858.CD001917.pub4 . Barr DA, Semple L, Seaton RA. Self-administration of outpatient parenteral antibiotic therapy and risk of catheter-related adverse events: a retrospective cohort study. Eur J Clin Microbiol Infect Dis. 2012;31(10):2611–9. https://doi:10.1007/s10096-012-1604-z . Bhavan KP, Brown LS, Haley RW. Self-Administered Outpatient Antimicrobial Infusion by Uninsured Patients Discharged from a Safety-Net Hospital: A Propensity-Score-Balanced Retrospective Cohort Study. PLoS Med. 2015;12(12):e1001922. https://doi:10.1371/journal.pmed.1001922 . Bodycot J, Mashonganyika L, Kucziw N, Ingham C, Bhukera S, White HA. Maximising the opportunity of a self-administration outpatient parenteral antimicrobial therapy pathway. Br J Nurs. 2021;30(2):S4–10. https://doi:10.12968/bjon.2021.30.2.S4 . Cox AM, Malani PN, Wiseman SW, Kauffman CA. Home intravenous antimicrobial infusion therapy: a viable option in older adults. J Am Geriatr Soc. 2007;55(5):645–50. https://doi:10.1111/j.1532-5415.2007.01133.x . Dubois-Silva Á, Otero-Plaza L, Dopico-Santamariña L, Mozo-Ríos A, Hermida-Porto L, Feal-Cortizas B, et al. Outpatient parenteral antimicrobial therapy with continuous infusion of meropenem: A retrospective analysis of three years of clinical experience. Enferm Infecc Microbiol Clin (Engl Ed). 2023;41(6):321–8. https://doi:10.1016/j.eimce.2021.11.012 . Durojaiye OC, Kritsotakis EI, Johnston P, Kenny T, Ntziora F, Cartwright K. Developing a risk prediction model for 30-day unplanned hospitalization in patients receiving outpatient parenteral antimicrobial therapy. Clin Microbiol Infect. 2019;25(7):905. https://doi:10.1016/j.cmi.2018.11.009 . .e1-905.e7 . Eaves K, Thornton J, Chapman AL. Patient retention of training in self-administration of intravenous antibiotic therapy in an outpatient parenteral antibiotic therapy service. J Clin Nurs. 2014;23(9–10):1318–22. https://doi:10.1111/jocn.12376 . Frieler S, Hanusrichter Y, Bellova P, Geßmann J, Schildhauer TA, Baecker H. Facing multidrug-resistant pathogens in periprosthetic joint infections with self-administered outpatient parenteral antimicrobial therapy-A prospective cohort study. J Orthop Res. 2021;39(2):320–32. https://doi:10.1002/jor.24906 . Ganguly A, de la Flor C, Alvarez K, Brown LS, Mang NS, Smartt J, et al. Safety and Efficacy of Ceftriaxone in the Treatment of Methicillin-Susceptible Staphylococcus aureus Bloodstream Infections: A Noninferiority Retrospective Cohort Study. Ann Pharmacother. 2023;57(4):425–31. https://doi:10.1177/10600280221115460 . Gardiol C, Voumard R, Cochet C, de Vallière S. Setting up an outpatient parenteral antimicrobial therapy (OPAT) unit in Switzerland: review of the first 18 months of activity. Eur J Clin Microbiol Infect Dis. 2016;35(5):839–45. 10.1007/s10096-016-2606-z . https:// . Hatcher J, Costelloe C, Cele R, Viljanen A, Samarasinghe D, Satta G, et al. Factors associated with successful completion of outpatient parenteral antibiotic therapy (OPAT): A 10-year review from a large West London service. Int J Antimicrob Agents. 2019;54(2):207–14. https://doi:10.1016/j.ijantimicag.2019.04.008 . Karimaghaei S, Rao A, Chijioke J, Finch N, Nigo M. Characteristics, safety and cost-effectiveness analysis of self-administered outpatient parenteral antibiotic therapy via a disposable elastomeric continuous infusion pump at two county hospitals in Houston, Texas, United States. J Clin Pharm Ther. 2022;47(2):211–7. https://doi:10.1111/jcpt.13550 . Keller SC, Dzintars K, Gorski LA, Williams D, Cosgrove SE. Antimicrobial Agents and Catheter Complications in Outpatient Parenteral Antimicrobial Therapy. Pharmacotherapy. 2018;38(4):476–81. https://doi:10.1002/phar.2099 . Keller SC, Cosgrove SE, Kohut M, Krosche A, Chang HE, Williams D, et al. Hazards from physical attributes of the home environment among patients on outpatient parenteral antimicrobial therapy. Am J Infect Control. 2019;47(4):425–30. https://doi:10.1016/j.ajic.2018.09.020 . Keller SC, Tamma P, Salinas A, Williams D, Cosgrove SE, Gurses AP. (a) Engaging Patients and Caregivers in a Transdisciplinary Effort to Improve Outpatient Parenteral Antimicrobial Therapy. Open Forum Infect Dis. 2020;7(6):ofaa188. https://doi:10.1093/ofid/ofaa18 Keller SC, Cosgrove SE, Arbaje AI, Chang RH, Krosche A, Williams D, Gurses AP, editors. (b) It's Complicated: Patient and Informal Caregiver Performance of Outpatient Parenteral Antimicrobial Therapy-Related Tasks. Am J Med Qual. 2020;35(2):133–146. https://doi:10.1177/1062860619853345 Keller SC, Salinas A, Gurses AP, Levering M, Hohl D, Hirsch D, et al. Implementing a Toolkit to Improve the Education of Patients on Home-Based Outpatient Parenteral Antimicrobial Therapy (OPAT). Jt Comm J Qual Patient Saf. 2022;48(9):468–74. https://doi:10.1016/j.jcjq.2022.05.008 . Kieran J, O'Reilly A, Parker J, Clarke S, Bergin C. Self-administered outpatient parenteral antimicrobial therapy: a report of three years' experience in the Irish healthcare setting. Eur J Clin Microbiol Infect Dis. 2009;28(11):1369–74. https://doi:10.1007/s10096-009-0794-5 . Kilinc F, Setzer M, Behmanesh B, Jussen D, Gessler F, Keil F (a) Safety and feasibility of outpatient parenteral antimicrobial therapy for patients with spinal infection, et al. editors. Sci Rep. 2023;13(1):6863. https://doi:10.1038/s41598-023-33502-7 Kilinc F, Setzer M, Behmanesh B, Jussen D, Gessler F, Bayerl S (b) Effectiveness of outpatient parenteral antimicrobial therapy (OPAT) for patients with cranial infection, et al. editors. Front Med (Lausanne). 2023;10:1202969. https://doi:10.3389/fmed.2023.1202969 Krah NM, Bardsley T, Nelson R, Esquibel L, Crosby M, Byington CL, et al. Economic Burden of Home Antimicrobial Therapy: OPAT Versus Oral Therapy. Hosp Pediatr. 2019;9(4):234–40. https://doi:10.1542/hpeds.2018-0193 . Lee B, Tam I, Weigel B 4th, Breeze JL, Paulus JK, Nelson J, et al. Comparative outcomes of β-lactam antibiotics in outpatient parenteral antibiotic therapy: treatment success, readmissions and antibiotic switches. J Antimicrob Chemother. 2015;70(8):2389–96. https://doi:10.1093/jac/dkv130 . López-Cortés LE, Ayerbe-García R, Carrasco-Hernández L, Fraile-Ramos E, Carmona-Caballero JM, Quintana-Gallego E, Valido-Morales A, et al. DOMUS OPAT Group. Outpatient Parenteral Antimicrobial Treatment for Non-Cystic Fibrosis Bronchiectasis Exacerbations: A Prospective Multicentre Observational Cohort Study. Respiration. 2019;98(4):294–300. https://doi:10.1159/000501085 . Mohammadi S, MacKay K, Ward TT, Forrest GN. Clinical outcomes of a veterans affairs outpatient antimicrobial treatment program. South Med J. 2013;106(6):345–9. https://doi:10.1097/SMJ.0b013e3182967e8f . Montón C, Pomares X, Mujal A. Home intravenous antimicrobial therapy in chronic respiratory disease. Arch Bronconeumol. 2013;49(4):174–5. https://doi:10.1016/j.arbres.2012.09.008 . English, Spanish. Mujal A, Sola J, Hernandez M, Villarino MA, Baylina M, Tajan J, et al. Safety and effectiveness of outpatient parenteral antimicrobial therapy in older people. J Antimicrob Chemother. 2016;71(5):1402–7. https://doi:10.1093/jac/dkv478 . Pajarón M, Lisa M, Fernández-Miera MF, Dueñas JC, Allende I, Arnaiz AM, et al. Efficiency of a self-administered outpatient parenteral antimicrobial therapy (s-opat) for infective endocarditis within the context of a shortened hospital admission based on hospital at home program. Hosp Pract. 2017;45(5):246–52. https://doi:10.1080/21548331.2017.1398588 . Ponce González MA, Mirón Rubio M, Mujal Martinez A, Estrada Cuxart O, Fiuza Perez D, Salas Reinoso L, et al. Effectiveness and safety of outpatient parenteral antimicrobial therapy in acute exacerbation of chronic obstructive pulmonary disease. Int J Clin Pract. 2017;71(12). https://doi:10.1111/ijcp.13022 . Saillen L, Arensdorff L, Moulin E, Voumard R, Cochet C, Boillat-Blanco N, et al. Patient satisfaction in an outpatient parenteral antimicrobial therapy (OPAT) unit practising predominantly self-administration of antibiotics with elastomeric pumps. Eur J Clin Microbiol Infect Dis. 2017;36(8):1387–92. https://doi:10.1007/s10096-017-2944-5 . Sanroma P, Muñoz P, Mirón-Rubio M, Aguilera A, Estrada O, García D, et al. Effectiveness and safety of ertapenem used in hospital-at-home units: data from Spanish Outpatient Parenteral Antimicrobial Therapy Registry. Future Microbiol. 2018;13:1363–73. https://doi:10.2217/fmb-2018-0065 . Schmidt-Hellerau K, Baade N, Günther M, Scholten N, Lindemann CH, Leisse C, et al. Outpatient parenteral antimicrobial therapy (OPAT) in Germany: insights and clinical outcomes from the K-APAT cohort study. Infection. 2024;52(4):1407–14. https://doi:10.1007/s15010-024-02199-9 . Seetoh T, Lye DC, Cook AR, Archuleta S, Chan M, Sulaiman Z, et al. An outcomes analysis of outpatient parenteral antibiotic therapy (OPAT) in a large Asian cohort. Int J Antimicrob Agents. 2013;41(6):569–73. https://doi:10.1016/j.ijantimicag.2013.01.015 . Sriskandarajah S, Ritchie B, Sluggett JK, Reynolds JGHAKJ. Safety of Nurse- and Self-Administered Paediatric Outpatient Parenteral Antimicrobial Therapy. Antibiot (Basel). 2020;9(11):761. https://doi:10.3390/antibiotics9110761 . Subedi S, Looke DF, McDougall DA, Sehu MM, Playford EG. Supervised self-administration of outpatient parenteral antibiotic therapy: a report from a large tertiary hospital in Australia. Int J Infect Dis. 2015;30:161–5. 10.1016/j.ijid.2014.11.021 . Twiddy M, Czoski Murray CJ, Mason SJ, Meads D, Wright JM, Mitchell ED, et al. CIVAS study team. A qualitative study of patients' feedback about Outpatient Parenteral Antimicrobial Therapy (OPAT) services in Northern England: implications for service improvement. BMJ Open. 2018;8(1):e019099. https://doi:10.1136/bmjopen-2017-019099 . Underwood J, Marks M, Collins S, Logan S, Pollara G. Intravenous catheter-related adverse events exceed drug-related adverse events in outpatient parenteral antimicrobial therapy. J Antimicrob Chemother. 2019;74(3):787–90. https://doi:10.1093/jac/dky474 . Yagnik KJ, Brown LS, Saad HA, Alvarez K, Mang N, Bird CE, et al. Implementation of IV Push Antibiotics for Outpatients During a National Fluid Shortage Following Hurricane Maria. Open Forum Infect Dis. 2022;9(5):ofac117. https://doi:10.1093/ofid/ofac117 . Zikri A, Al-Faraj H, Kamas N, Al Zahrani J, Bu Khamseen H, Alshahoub W, et al. Implementing the First Outpatient Parenteral Antimicrobial Therapy (OPAT) Program to Utilize Disposable Elastomeric Pumps in the Gulf Region: Results From a Tertiary Teaching Hospital in the Kingdom of Saudi Arabia. Cureus. 2021;13(12):e20179. https://doi:10.7759/cureus.20179 . Eskes AM, Tobiano G, Carlini J, Kuijpers C, Musters SCW, Chaboyer W. Fundamentally shifting discharge planning and post-hospital care. Int J Nurs Stud. 2023;145:104533. https://doi:10.1016/j.ijnurstu.2023.104533 . Levoy K, Rivera E, McHugh M, Hanlon A, Hirschman KB, Naylor MD. Caregiver Engagement Enhances Outcomes Among Randomized Control Trials of Transitional Care Interventions: A Systematic Review and Meta-analysis. Med Care. 2022;60(7):519–29. https://doi:10.1097/MLR.0000000000001728 . Chapman ALN, Patel S, Horner C, Green H, Guleri A, Hedderwick S, et al. Updated good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults and children in the UK. JAC Antimicrob Resist. 2019;1(2):dlz026. https://doi:10.1093/jacamr/dlz026 . Carter B, Carrol ED, Porter D, Peak M, Taylor-Robinson D, Fisher-Smith D, et al. Delivery, setting and outcomes of paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT): a scoping review. BMJ Open. 2018;8(11):e021603. https://doi:10.1136/bmjopen-2018-021603 . Mahoney MV, Childs-Kean LM, Khan P, Rivera CG, Stevens RW, Ryan KL. Recent Updates in Antimicrobial Stewardship in Outpatient Parenteral Antimicrobial Therapy. Curr Infect Dis Rep. 2021;23(12):24. https://doi:10.1007/s11908-021-00766-x . Saldanha IJ, Dodd S, Gorst SL, Williamson PR. More than half of systematic reviews have relevant core outcome sets. J Clin Epidemiol. 2021;136:168–79. https://doi:10.1016/j.jclinepi.2021.04.019 . Mohammed SA, Cotta MO, Assefa GM, Erku D, Sime F. Barriers and facilitators for the implementation and expansion of outpatient parenteral antimicrobial therapy: a systematic review. J Hosp Infect. 2024;147:1–16. https://doi:10.1016/j.jhin.2024.02.006 . Berrevoets MAH, Ten Oever J, Oerlemans AJM, Kullberg BJ, Hulscher ME, Schouten JA. Quality Indicators for Appropriate Outpatient Parenteral Antimicrobial Therapy in Adults: A Systematic Review and RAND-modified Delphi Procedure. Clin Infect Dis. 2020;70(6):1075–82. https://doi:10.1093/cid/ciz362 . Wolly ZT, Roberts JA, Gilchrist M, McCarthy K, Sime FB. Current practices and challenges of outpatient parenteral antimicrobial therapy: a narrative review. J Antimicrob Chemother. 2024;79(9):2083–102. https://doi:10.1093/jac/dkae177 . Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3(1):e001570. https://doi:10.1136/bmjopen-2012-001570 . Manary MP, Boulding W, Staelin R, Glickman SW. The patient experience and health outcomes. N Engl J Med. 2013;368(3):201–3. https://doi:10.1056/NEJMp1211775 . Bellamy R. Outpatient parenteral antimicrobial therapy. Br J Hosp Med (Lond). 2018;79(1):12–7. 10.12968/hmed.2018.79.1.12 . https:// . Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20(10):1727–36. https://doi:10.1007/s11136-011-9903-x . Brouwer WB, van Exel NJ, van Gorp B, Redekop WK. The CarerQol instrument: a new instrument to measure care-related quality of life of informal caregivers for use in economic evaluations. Qual Life Res. 2006;15(6):1005–21. https://doi:10.1007/s11136-005-5994-6 . Benson T, Potts HWW, Bark P, Bowman C. Development and initial testing of a Health Confidence Score (HCS). BMJ Open Qual. 2019;8(2):e000411. https://doi:10.1136/bmjoq-2018-000411 . Al-Janabi H, Frew E, Brouwer W, Rappange D, Van Exel J. The inclusion of positive aspects of caring in the Caregiver Strain Index: tests of feasibility and validity. Int J Nurs Stud. 2010;47(8):984–93. https://doi:10.1016/j.ijnurstu.2009.12.015 . Bonsel JM, Itiola AJ, Huberts AS, Bonsel GJ, Penton H. The use of patient-reported outcome measures to improve patient-related outcomes - a systematic review. Health Qual Life Outcomes. 2024;22(1):101. https://doi:10.1186/s12955-024-02312-4 . Challener DW, Fida M, Martin P, Rivera CG, Virk A, Walker LW. Machine learning for adverse event prediction in outpatient parenteral antimicrobial therapy: a scoping review. J Antimicrob Chemother. 2024;79(12):3055–62. https://doi:10.1093/jac/dkae340 . Kouwenberg LHJA, Cohen ES, Hehenkamp WJK, Snijder LE, Kampman JM, Küçükkeles B, et al. The Carbon Footprint of Hospital Services and Care Pathways: A State-of-the-Science Review. Environ Health Perspect. 2024;132(12):126002. https://doi:10.1289/EHP14754 . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 12 May, 2025 Read the published version in Infection → Version 1 posted Editorial decision: Accepted 28 Apr, 2025 Reviews received at journal 28 Apr, 2025 Reviewers agreed at journal 08 Apr, 2025 Reviewers invited by journal 08 Apr, 2025 Editor assigned by journal 08 Apr, 2025 Submission checks completed at journal 07 Apr, 2025 First submitted to journal 07 Apr, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6390941","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":441193756,"identity":"a594c075-dbc0-421c-85aa-5ac12a5c2523","order_by":0,"name":"Jolanda Maaskant","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABDklEQVRIiWNgGAWjYBACxgYoQwJEfEDmgGQPENDC2DgDyOBB0sKATQscgLQ08xCjhbmBO4HpRo2dvWT72eOPbWq22duz9z688TPncDR/A+8B7A7j3cCccyw5cTZPXmJzzrHbiT08x40te7cdzp1xgC8BtxY25gQ5hhzD5hy22wk8EmlsErxALRsYeAxwa/lXby/H/8aw2eLfbXse+Wdskn8JacltO8w4WwJoC2PbbcYeCTY2aby2NPNuOJzbdzxx5ow3hjN7+4B+OZPGbC27LT13xmHsWgzbezc+zvlWbS9xPsfgw49vt+3Z248x3ny7zTq3v73H8AE2Lc2444sZu7A8DuWjYBSMglEwChAAANC/Z0407D7pAAAAAElFTkSuQmCC","orcid":"","institution":"Amsterdam University Medical Center, Department of Internal Medicine","correspondingAuthor":true,"prefix":"","firstName":"Jolanda","middleName":"","lastName":"Maaskant","suffix":""},{"id":441193757,"identity":"2bf8fc1b-a3da-4078-bde8-1b339bce6dcb","order_by":1,"name":"Tessa de Vries","email":"","orcid":"","institution":"Amsterdam University Medical Center, Department of Internal Medicine, Division of Infectious Diseases","correspondingAuthor":false,"prefix":"","firstName":"Tessa","middleName":"","lastName":"de Vries","suffix":""},{"id":441193758,"identity":"907986f7-b0d4-4f1b-9efd-470ab4c8e19d","order_by":2,"name":"Laura Volle","email":"","orcid":"","institution":"University of Amsterdam","correspondingAuthor":false,"prefix":"","firstName":"Laura","middleName":"","lastName":"Volle","suffix":""},{"id":441193759,"identity":"e42295f5-2ac3-45bb-b351-93b6301d888f","order_by":3,"name":"Faridi Jamaludin","email":"","orcid":"","institution":"Amsterdam University Medical Center, Research Support, Medical library","correspondingAuthor":false,"prefix":"","firstName":"Faridi","middleName":"","lastName":"Jamaludin","suffix":""},{"id":441193760,"identity":"01f41166-d639-433f-8fd9-d7e6c124f832","order_by":4,"name":"Suzanne Geerlings","email":"","orcid":"","institution":"Amsterdam University Medical Center, Department of Internal Medicine, Division of Infectious Diseases","correspondingAuthor":false,"prefix":"","firstName":"Suzanne","middleName":"","lastName":"Geerlings","suffix":""},{"id":441193761,"identity":"3a2bbde3-a226-478e-9653-7bf6a087dbb8","order_by":5,"name":"Kim Sigaloff","email":"","orcid":"","institution":"Amsterdam University Medical Center, Department of Internal Medicine, Division of Infectious Diseases","correspondingAuthor":false,"prefix":"","firstName":"Kim","middleName":"","lastName":"Sigaloff","suffix":""}],"badges":[],"createdAt":"2025-04-07 06:53:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6390941/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6390941/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s15010-025-02549-1","type":"published","date":"2025-05-12T15:58:12+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":80710658,"identity":"f601e089-339d-4e62-9362-bc334bfa27e9","added_by":"auto","created_at":"2025-04-16 09:00:53","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":409029,"visible":true,"origin":"","legend":"\u003cp\u003eSelection process\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6390941/v1/d6194eff911c4e48e3d482db.jpeg"},{"id":83067877,"identity":"0c6effbf-0a81-4669-9603-2ef5613db432","added_by":"auto","created_at":"2025-05-19 16:07:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2106374,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6390941/v1/e8f12df9-7434-4852-bda9-0ccb18eaf04e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Clinical and patient-reported outcomes of Self-administered Outpatient Parenteral Antimicrobial Treatment (S-OPAT): a scoping review","fulltext":[{"header":"Introduction","content":"\u003cp\u003eOutpatient parenteral antimicrobial therapy (OPAT), as defined by the Infectious Diseases Society of America, is \u0026lsquo;the administration of at least two doses of parenteral microbial therapy on different days without intervening hospitalization' [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This approach allows patients who require parenteral antibiotic treatment to be discharged from the hospital, provided they are stable enough to continue their care at home. Since its inception in the 1970s, OPAT has been increasingly employed to facilitate medical treatment in a familiar environment, increase patient autonomy, reduce costs, increase hospital bed availability, and reduce the risk of nosocomial infections [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. A recent systematic review shows that OPAT is a safe and effective alternative to inpatient treatment [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSelf-administered OPAT (S-OPAT) is a variant of OPAT in which parenteral antimicrobial treatment is administered by patients themselves, family members, or other caregivers, typically in the home setting. The term was coined in 2007 to distinguish this model from OPAT administered by healthcare [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. However, the concept dates back further, as the first clinical report on OPAT already describes self-administration of treatment [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The advantage of S-OPAT is that it does not require dedicated mobile healthcare professionals for administration visits. Ideally, S-OPAT reduces healthcare staffing demands and costs, provides patients with greater control over their schedules, and enables the extramural use of antimicrobials administered in multiple doses per day, all while maintaining safety and effectiveness of treatment [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eA survey performed among experts from 28 European countries concluded that S-OPAT is offered in 10 countries but is considered standard practice only in Switzerland and the United Kingdom [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Wider use of S-OPAT may be hampered by uncertainty on its clinical outcomes and safety compared to other OPAT administration models. Moreover, there is a need for further understanding of which patients are best suited for S-OPAT, the factors that influence treatment outcomes, and the experiences of patients and their caregivers [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this context, the aim of this scoping review is to provide a comprehensive overview of the existing literature on S-OPAT, focusing on clinical outcomes and safety of S-OPAT, factors influencing these outcomes, and the experiences of patients and caregivers. In addition, we aimed to identify gaps in knowledge and future directions of research.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eWe performed a scoping review guided by the Joanna Briggs Institute methodology for scoping reviews [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] and reported according to the PRISMA extension for scoping reviews recommendations (PRISMA-ScR) [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eSearch strategy.\u003c/span\u003e \u003c/p\u003e \u003cp\u003eThe search strategy was developed in consultation with a medical librarian of Amsterdam University Medical Centre (FJ). Search terms were based on the key components of S-OPAT: self-administration, outpatient setting, parenteral/intravenous administration, and antimicrobial agents. We searched the following online databases: MEDLINE, CINAHL, Embase and Cochrane library. As the term S-OPAT was first established in 2007, the search was limited to the period between 2007 and the search date (21 March 2024). We applied no restrictions based on language or geographical origin. The final search strategy is presented in Appendix A.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eEligibility criteria\u003c/h2\u003e \u003cp\u003eConsidered for inclusion were publications providing information on the clinical outcome and safety of parenteral antimicrobial treatment administered by patients or their caregivers in an outpatient setting, or on the experiences of patients and caregivers involved in S-OPAT administration. We excluded publications that studied different OPAT delivery models but did not report results on S-OPAT separately. Participants of interest were any patients, including children, undergoing S-OPAT. Caregivers were considered participants of interest only in the context of their experiences with aiding with or administering the antimicrobial treatment. Primary research studies (quantitative, qualitative, and mixed methods), quality improvement reports, (systematic) reviews and guidelines were eligible for inclusion. We excluded editorials, letters to the editor, publications reporting the results of the same study, case studies, and guidance documents.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy selection\u003c/h3\u003e\n\u003cp\u003eAfter removal of the duplicates, titles and abstracts were screened by two reviewers independently (LV, JMM). Disagreements were resolved by discussion and in consultation with a third reviewer (KS). In case of persistent uncertainty, a publication was passed onto the full text stage. All publications that were considered potentially relevant were screened full text by one reviewer (LV), with regular team discussions throughout the process. The reference lists of all included publications were hand-searched to seek for additional relevant publications. When full text was not available, corresponding authors were contacted. Rayyan Systems Inc. was used for managing the selection process. The literature selection process and results are visualized in a PRISMA flow chart.\u003c/p\u003e\n\u003ch3\u003eData charting and synthesis of results\u003c/h3\u003e\n\u003cp\u003eA data extraction form was constructed and piloted on 5 randomly selected publications and refined throughout this process. Data of the remaining publications were extracted by two reviewers (JMM, TV) independently. We resolved disagreements by consensus and discussion with the research team. After several discussion rounds, all researchers agreed upon the final version of the charting tables.\u003c/p\u003e \u003cp\u003eWe extracted characteristics of the study, i.e. authors, year and country of publication, and study type. Furthermore, we collected data describing the population, the antimicrobial treatment, and the outcomes. The outcomes were divided into clinical outcomes (e.g. success and failure of the treatment) and safety (e.g. complications, adve\u003cb\u003er\u003c/b\u003ese events, hospitalizations, mortality) as defined in the publications. In addition, we extracted factors reported to impact the clinical outcomes and safety. Experiences of patients and caregivers were looked for both quantitatively and qualitatively. No quality assessment was executed, because scoping reviews are conducted to provide an overview of the existing evidence regardless of methodological quality or risk of bias [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWe summarized findings of the included studies by the types of outcomes narratively as well as in tabular form. If publications report on different OPAT delivery models, we only considered the S-OPAT data. Qualitative data on the outcome of interest were summarized, and descriptive statistics were used to present the quantitative data.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eAfter deduplication, the literature search yielded 353 potentially relevant publications, 219 of which were selected for full-text screening. The full text of 5 publications could not be retrieved. We excluded 170 publications based on the full-text screening, resulting in 44 studies for final inclusion [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36 CR37 CR38 CR39 CR40 CR41 CR42 CR43 CR44 CR45 CR46 CR47 CR48 CR49 CR50 CR51\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Cross-checking the reference lists did not yield new publications. The selection process is visualized in Fig.\u0026nbsp;1.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e\n\u003ch3\u003eCharacteristics of the included studies\u003c/h3\u003e\n\u003cp\u003eThe characteristics of the 44 included studies are presented in Table\u0026nbsp;1.\u003c/p\u003e \u003cp\u003ePublications from 9 countries were included. Fifteen publications originated from the United States of America [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan additionalcitationids=\"CR27 CR28 CR29 CR30\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e], 10 from the United Kingdom [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e] and 8 from Spain [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan additionalcitationids=\"CR40 CR41\" citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. Other publications originated from Germany [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e], Australia [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], Switzerland [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e], Ireland [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], Singapore [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e], and the Kingdom of Saudi Arabia [\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTwo systematic reviews [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], one guideline [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], and 41 publications reporting original data were included [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36 CR37 CR38 CR39 CR40 CR41 CR42 CR43 CR44 CR45 CR46 CR47 CR48 CR49 CR50 CR51\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. In total we found 35 cohort studies; 22 were retrospective [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR16 CR17 CR18 CR19\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan additionalcitationids=\"CR33\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e], 12 prospective [13, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e], and 1 study used a combination [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEleven studies compared S-OPAT with OPAT [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e], 1 study compared S-OPAT with oral antibiotic therapy [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], and 9 studies explored factors influencing the clinical or safety outcomes of S-OPAT [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Fourteen studies described the findings in a single cohort [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Other studies used qualitative study designs [\u003cspan additionalcitationids=\"CR29\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e] or surveys [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan additionalcitationids=\"CR32 CR33\" citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThree publications reported results of a paediatric population [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e]. Thirteen publications focused on specific patient groups, i.e. non-injecting drug users [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e],\u003c/p\u003e \u003cp\u003euninsured patients [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], patients with periprosthetic joint infections [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], spinal infections [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e], cranial infections [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e], chronic respiratory diseases [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e], musculoskeletal infections [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e], and endocarditis [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Caregivers of adult patients participated in two studies [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e], and caregivers of pediatric patients in one [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of included studies\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003eAggregated publications\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAuthor, date\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCountry\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eType of publication\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo of studies included\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eType of studies included\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003ePopulation\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBalaguer, 2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSystematic review\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eRandomized controlled trial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eAdults and children with cystic fibrosis receiving intravenous antimicrobial treatment at home or in hospital\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMitchell, 2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSystematic review\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal 128\u003c/p\u003e \u003cp\u003eS-OPAT 66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eAll studies, except case reports, reporting on OPAT and S-OPAT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eAdult patients treated for any condition (and/or their caregivers), or practitioners involved in the delivery of OPAT\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNorris, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eClinical guideline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eAdults and children treated for any condition\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c8\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrimary studies\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStudy or publication\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e\u003cb\u003ePopulation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u003cb\u003eAntimicrobial treatment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAuthor, date\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eCountry\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eType\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eParticipants\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eSample size\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eIndications\u003c/b\u003e\u003csup\u003e\u003cb\u003e1\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003eAntimicrobial agents\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003eDuration\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAkar, 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective chart review\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChildren, 53% with chronic underlying illnesses.\u003c/p\u003e \u003cp\u003eMean age 8.4 y.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 183\u003c/p\u003e \u003cp\u003eEpisodes 210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMusculoskeletal, bloodstream, pulmonary and intra-abdominal infections\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCefazolin, ceftriaxone, ceftazidim, clindamycin, ertapenem, vancomycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean 16 d. (range\u003c/p\u003e \u003cp\u003e2\u0026ndash;53)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAppa, 2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients with and without non-injecting drug use.\u003c/p\u003e \u003cp\u003eMedian age 51 y.\u003c/p\u003e \u003cp\u003e(IQR 40\u0026ndash;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 72:\u003c/p\u003e \u003cp\u003e- Drug users 35\u003c/p\u003e \u003cp\u003e- No drug users 37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBacteremia, osteomyelitis, abscess/complex soft tissue infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBarr, 2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eMean age 55.1 y. (IQR 45.8\u0026ndash;68.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEpisodes 854\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian 41 d. (range 25.8\u0026ndash;65.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBhavan, 2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective\u003c/p\u003e \u003cp\u003ecohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUninsured patients.\u003c/p\u003e \u003cp\u003eRange age 16 -\u003c/p\u003e \u003cp\u003e\u0026ge;\u0026thinsp;65 y.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 1168:\u003c/p\u003e \u003cp\u003e- S-OPAT 944\u003c/p\u003e \u003cp\u003e- OPAT 224\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eInfections bone and joint, skin and soft tissue, CNS, intra-abdominal, genitourinary, pulmonary, ENT, and bacteremia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian 26 d. at home\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBodycot, 2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 958\u003c/p\u003e \u003cp\u003eEpisodes 1084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDiabetic foot, urinary tract, and prosthetic knee-joint infections, osteomyelitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCox, 2007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdults patients. Total group mean age 58.8 y. (range 23\u0026ndash;83).\u003c/p\u003e \u003cp\u003eGroup age\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;60 y. 68.9 y. (SD 8.9).\u003c/p\u003e \u003cp\u003eGroup age\u0026thinsp;\u0026lt;\u0026thinsp;60 y. 50.6 y. (SD 8.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 205 Episodes 231:\u003c/p\u003e \u003cp\u003e- Age\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;60 y. 107 courses\u003c/p\u003e \u003cp\u003e- Age\u0026thinsp;\u0026lt;\u0026thinsp;60 y. 124 courses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOsteoarticular, skin and soft tissue infections, bacteremia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCefazolin, ceftriaxone, ertapenem, vancomycin,\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eGroup age\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;60 y. median 22 d. (range 2\u0026ndash;107)\u003c/p\u003e \u003cp\u003eGroup age\u0026thinsp;\u0026lt;\u0026thinsp;60 y. median 29.5 d. (range 4\u0026ndash;450)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDubois-Silva, 2023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEpisodes 31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMeropenem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDurojaiye, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEaves, 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective clinical evaluation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients,\u003c/p\u003e \u003cp\u003emean age 52 y. (range 21\u0026ndash;79).\u003c/p\u003e \u003cp\u003eCaregivers, mean age 63 y. (range 50\u0026ndash;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 29 Caregivers 9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eWide range, e.g. discitis, endocarditis, osteomyelitis and lung abscess\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian 42 d. (range 28\u0026ndash;168)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrieler, 2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGermany\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdults patients. Mean age 66 y. (SD 15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 26 (23 with complete follow-up)\u003c/p\u003e \u003cp\u003eEpisodes 54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePeriprosthetic joint infections and multidrug-resistant pathogens\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMeropenem, vancomycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean 66 d. (SD 26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGanguly, 2023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNoninferiority retrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUninsured adults patients. Mean age 50 y. (SD 13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 368:\u003c/p\u003e \u003cp\u003e- Group Cefazolin 286\u003c/p\u003e \u003cp\u003e- Group Ceftriaxone 82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMethicillin-susceptible Staphylococcus aureus infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCefazolin, ceftriaxone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean 35 d. (SD 18)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGardiol, 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSwitzerland\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective cohort evaluation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHatcher, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective analysis of prospectively collected data\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEpisodes 1793:\u003c/p\u003e \u003cp\u003e- S-OPAT 252\u003c/p\u003e \u003cp\u003e- OPAT 1541\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKarimaghael, 2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients with an elastomeric continuous infusion pump.\u003c/p\u003e \u003cp\u003eMean age 49.3 y. (SD 14.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNeurosyphylis, ocular/otosyphilis, osteomyelitis/septic arthritis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNafcillin, penicillin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean 20.4 d. (SD 20.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeller, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patient, median age 55 y. (IQR 41\u0026ndash;63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 399\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBacteremia, abdominal infection, osteomyelitis, septic arthritis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCeftriaxone, penicillins, piperacillin-tazobactam, vancomycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian 29 d. (IQR 15\u0026ndash;44)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeller, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eQualitative study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eInterviews mean age 55 y. (ST 11.5).\u003c/p\u003e \u003cp\u003eObservations mean age 51.5 y. (SD 15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 43\u003c/p\u003e \u003cp\u003e- Interviews 29\u003c/p\u003e \u003cp\u003e- Observations 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeller, 2020 (a)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eQualitative study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients and caregivers.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 7\u003c/p\u003e \u003cp\u003eCaregivers 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeller, 2020 (b)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eQualitative study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eInterviews mean age 55.4 y. (SD 12.5).\u003c/p\u003e \u003cp\u003eObservations mean age 52 y. (SD 14.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 60:\u003c/p\u003e \u003cp\u003e- Interviews 40\u003c/p\u003e \u003cp\u003e- Observations 20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeller, 2022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSurvey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eMean age 57.5 y.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKieran, 2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIreland\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective analysis of prospectively collected data\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 56\u003c/p\u003e \u003cp\u003eEpisodes 60:\u003c/p\u003e \u003cp\u003e- S-OPAT 48 OPAT 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKilinc, 2023 (a)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGermany\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eMedian age 52 y. (range 27\u0026ndash;85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSpinal infections, such as spondylodiscitis and spinal empyema\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCefazolin, ceftriaxone, Fosfomycin, vancomycin,\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean 41.3 d. (SD 16.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKilinc, 2023 (b)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGermany\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eMedian age 49 y. (range 20\u0026ndash;71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCranial infections\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCefazolin, ceftriaxone, fosfomycin, meropenem, vancomycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean 41.1 d. (SD 14)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKrah, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChildren and their caregivers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients and caregivers 89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCentral nervous system, osteomyelitis and/or septic arthritis, endocarditis, pneumonia, intra-abdominal infection, musculoskeletal with hardware\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCefazolin, ceftriaxone, ertapenem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eAntimicrobial use duration median 39 d. (IQR 24\u0026ndash;95)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLee, 2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective\u003c/p\u003e \u003cp\u003ereview\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients. Mean age 58 (SD 17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOsteoarticular infections, bacteremia, abscess\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCefazolin, ceftriaxone, ertapenem, oxacillin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLopez-Cortes, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eMedian age 71 y. (IQR 56\u0026ndash;80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eExacerbation of Non-Cystic Fibrosis Bronchiectasis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCeftazidime, piperacillin/tazobactam, combination including meropenem, tobramycin,\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian 12 d.\u003c/p\u003e \u003cp\u003e(IQR 9\u0026ndash;13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMatthew, 2007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eS-OPAT mean age 46.2 y.\u003c/p\u003e \u003cp\u003eOPAT mean age 60.9 y.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEpisodes 2482:\u003c/p\u003e \u003cp\u003e- S-OPAT 473\u003c/p\u003e \u003cp\u003e- OPAT 2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMusculoskeletal infections (both groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCeftriaxone, teicoplanin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMode 6 weeks both\u003c/p\u003e \u003cp\u003eS-OPAT and OPAT\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMohammadi, 2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective chart review\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients. Mean age 63.2 (range 31\u0026ndash;87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOsteomyelitis, urinary tract, skin and soft tissue, bloodstream, and prosthetic joint infection, endocarditis.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCeftriaxone, nafcillin, vancomycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian 30 d. (range 5\u0026ndash;56)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonton, 2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients. Mean age 64 (SD 17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 50\u003c/p\u003e \u003cp\u003eEpisodes 74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eExacerbation of a chronic respiratory disease\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean 19 d. (SD 13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMujal, 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eGroup\u0026thinsp;\u0026lt;\u0026thinsp;65 y. mean age 47.7 y. (SD 13.3).\u003c/p\u003e \u003cp\u003eGroup 65\u0026ndash;79 y. mean age 72.3 y. (SD 4.1).\u003c/p\u003e \u003cp\u003eGroup\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;80 y. mean age 84.9 y. (SD 3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 420:\u003c/p\u003e \u003cp\u003e- Group\u0026thinsp;\u0026lt;\u0026thinsp;65 y. 139\u003c/p\u003e \u003cp\u003e- Group 65\u0026ndash;79 y. 182\u003c/p\u003e \u003cp\u003e- Group\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;80 y. 99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRespiratory, urinary, intra-abdominal, osteoarticular, skin infections\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCeftriaxone, cefepime/ceftazidime, ertapenem, meropenem, piperacillin/tazobactam, vancomycin/teicoplanin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePajaron, 2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCohort study with retrospectively and prospectively collected data\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdults patient.\u003c/p\u003e \u003cp\u003eMean age 61 (SD 16.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 54\u003c/p\u003e \u003cp\u003eEpisodes 57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eInfectious endocarditis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAmpicillin, ceftriaxone,\u003c/p\u003e \u003cp\u003ecloxacillin, daptomycin, linezolid, penicillin G, teicoplanin, vancomycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean 3.1 w. (SD 0.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePonce Gonzalez, 2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdults patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAcute exacerbation of COPD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAmikacin, cefepime, ceftazidim, ceftriaxone, ertapenem, levofloxacin, meropenem, piperacillin/\u003c/p\u003e \u003cp\u003etazobactam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSaillen, 2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSwitzerland\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSurvey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patient.\u003c/p\u003e \u003cp\u003eMean age 56 y. (SD 15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOsteoarticular, urinary tract, endovascular, intra-abdominal, skin and soft-tissue infections, endocarditis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean 19.2 d. (SD 16.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSanroma, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 371\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eErtapenem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian 9 d. (range 6\u0026ndash;13)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSchmidt-Hellerau, 2024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGermany\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspectively observational study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eMedian age 56 y. (IQR 40\u0026ndash;66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eJoint and bone infections, vertebral osteomyelitis, periprosthetic joint infection, septic arthritis, bacteremia, endocarditis, neurosyphylis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCeftriaxone, flucloxacillin,\u003c/p\u003e \u003cp\u003eMeropenem, penicillin, vancomycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian 15 d. (IQR 11\u0026ndash;26, range 5\u0026ndash;127)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeetoh, 2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingapore\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEpisodes 397\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSriskandarajah, 2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAustralia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective review\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePediatric patients.\u003c/p\u003e \u003cp\u003eMean age 9.13 (SD 5.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEpisodes 100:\u003c/p\u003e \u003cp\u003e- S-OPAT 49\u003c/p\u003e \u003cp\u003e- OPAT 51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCystic fibrosis, osteomyelitis, pneumonia, septic arthritis, bacteremia, primary ciliary dyskinesia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTobramycin in combination with ceftazidime or piperacillin/tazobactam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian 14.5 d.\u003c/p\u003e \u003cp\u003e(IQR 14.5 -24.75).\u003c/p\u003e \u003cp\u003eOPAT median 11 d. (IQR 8\u0026ndash;14)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubedi, 2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAustralia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective analysis of prospectively collected data\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003cp\u003eMedina age 55 (range 16\u0026ndash;90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 144\u003c/p\u003e \u003cp\u003eEpisodes 150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOsteomyelitis, septic arthritis, endocarditis, bacteremia, skin and soft-tissue, surgical site, central nervous system, and intra-abdominal infections\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eBenzylpenicillin, cefazolin, ceftazidime, ceftriaxone, clavulanic acid, ertapenem, flucloxacillin, lincomycin, meropenem, teicoplatin ticarcillin-Vancomycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMedian 22 d. (range 4\u0026ndash;106)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTwiddy, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eQualitative study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patient.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnderwood, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUK\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective analysis of prospectively collected data\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEpisodes 30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYagnik, 2022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRetrospective chart review\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdult patients. Mean age 49 y. (SD 13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEpisodes 200:\u003c/p\u003e \u003cp\u003e- Drip infusion method 95\u003c/p\u003e \u003cp\u003e- Prefilled syringe delivery method 105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBone and joint infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCefazolin, cefepime, ceftriaxone, daptomycin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZikri, 2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSAU\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProspective cohort study\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdults patients.\u003c/p\u003e \u003cp\u003eMean age 53 y. (range 17\u0026ndash;77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePatients 47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eUrinary tract, diabetic foot, respiratory tract, intra-abdominal and cardiovascular infections\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCeftriaxone, Imipenem, meropenem, piperacillin/tazobactam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eCNS: Central Nervous System; COPD: Chronic Obstructive Pulmonary Disease; ENT: Ear/Nose/Throat; IQR: interquartile range; NA: not applicable; NR: not reported (for the S-OPAT participants); PICC: peripherally inserted central catheter; SD: standard deviation; SAU: Kingdom of Saudi Arabia; TCVC: tunneled central venous catheter; UK: United Kingdom; USA: United States of America; y: years; d: days; w: weeks.\u003c/p\u003e \u003cp\u003e \u003csup\u003e1\u003c/sup\u003e Most frequently reported indication; \u003csup\u003e2\u003c/sup\u003e Most frequently reported antimicrobial agents\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eAggregated publications of S-OPAT\u003c/h2\u003e \u003cp\u003eOur search yielded two systematic reviews [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] and one guideline [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The systematic review by Mitchell et al. included 128 studies that evaluated existing evidence on the efficacy, safety, acceptability, and cost-effectiveness of different OPAT delivery models. Studies that evaluated S-OPAT as a single model of delivery were few (16/128, 12.5%) and published before the inclusion period of our review [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The systematic review by Balaguer et al. included one randomized controlled trial evaluating S-OPAT versus hospital intravenous antibiotic treatment for cystic fibrosis [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. This study originated from 1997 and was therefore excluded from our review. The 2018 IDSA guidelines strongly recommend patients to be allowed self-administration, based on low-quality evidence, but on vast clinical experience with S-OPAT [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eOutcomes reported in the primary studies.\u003c/span\u003e \u003c/p\u003e \u003cp\u003eClinical and safety outcomes of S-OPAT are presented in Table\u0026nbsp;2.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eClinical outcome\u003c/h3\u003e\n\u003cp\u003eWe found 17 publications reporting on clinical outcomes [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan additionalcitationids=\"CR33\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan additionalcitationids=\"CR45 CR46\" citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e], of which 5 studies evaluated the clinical outcome of S-OPAT in comparison with OPAT care delivered by healthcare professionals, either in specialized OPAT clinics [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e], at the patients\u0026rsquo; homes [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e], or a combination [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eComparison of S-OPAT with OPAT delivered by healthcare professionals at the patients\u0026rsquo; homes, e.g. community nurses, showed no differences in clinical outcome [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e]. The study by Hatcher et al. also compared outcomes of S-OPAT patients with patients receiving care at specialized OPAT clinics. Their results showed that clinic-based OPAT was associated with an increased odds of OPAT success, defined as survival without readmission (OR 2.1, 95%CI 1.03\u0026ndash;2.28, p\u0026thinsp;=\u0026thinsp;0.02) [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. However, Seetoh et al. reported no significant difference between S-OPAT and clinic-based OPAT on unplanned readmission or death [\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eSafety\u003c/h3\u003e\n\u003cp\u003eWe found 23 publications reporting on safety [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan additionalcitationids=\"CR25\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan additionalcitationids=\"CR33\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e]. Nine studies evaluated the safety of S-OPAT in comparison with OPAT care delivered by healthcare professionals, either in specialized OPAT clinics [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e], at the patients\u0026rsquo; homes [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e], or a combination [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBhavan et al. reported a significant difference between S-OPAT and a healthcare professional OPAT model on 30-days all cause readmission in favor of S-OPAT (16.7% versus 23.7%, adjusted HR 0.53, 95%CI 0.35\u0026ndash;0.81, p\u0026thinsp;=\u0026thinsp;0.003) [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. No significant differences were found between S-OPAT and other OPAT delivery models on catheter events [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e], adverse drug events [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e], complications [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], infection-related complications [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e], readmissions [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e], and mortality [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThree publications evaluated S-OPAT as a potential risk factor for adverse safety outcomes [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. S-OPAT was not associated with 30-days unplanned hospitalization [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. However, S-OPAT was significantly associated with the risk for adverse events (adjusted OR 6.25, 95%CI 1.44\u0026ndash;27.15) [\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e], and catheter-related adverse events (HR 4.15, 95%CI 1.7\u0026ndash;9.1, p\u0026thinsp;=\u0026thinsp;0.007) [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical outcomes and safety of S-OPAT\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAuthor, date\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eClinical outcomes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eSafety\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDefinition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eResults\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDefinitions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eResults\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eComparative studies\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBarr, 2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Line infection (local infection, bloodstream infection)\u003c/p\u003e \u003cp\u003e- Other line events (chemical or mechanical phlebitis, leakage, extravasation, occlusion, non-electively removal)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eS-OPAT versus OPAT (corrected for confounders):\u003c/p\u003e \u003cp\u003e- Line infection 11/532 (2%) versus 9/298 (2.9%), NS\u003c/p\u003e \u003cp\u003e- Other line events 91/452 (16.8%) versus 34/273 (11.1%), NS\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBhavan, 2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- 30-days all cause readmission\u003c/p\u003e \u003cp\u003e- 1-year all cause mortality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eS-OPAT versus OPAT (corrected for confounders):\u003c/p\u003e \u003cp\u003e- Readmission 158/944 (16.7%), versus 53/224 (23.7%), HR 0.53, p\u0026thinsp;=\u0026thinsp;0.003\u003c/p\u003e \u003cp\u003e- Mortality 51/944 (5.4%) versus 10/244 (4.5%), NS\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDurojaiye, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30-days unplanned hospitalization\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eIn a multivariable model, S-OPAT was not significantly associated with 30-days unplanned hospitalization, NS\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHatcher, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eS-OPAT success (no readmission due to infection worsening or due to adverse event, and no mortality by any cause during OPAT)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eS-OPAT success 233/252 (92.5%)\u003c/p\u003e \u003cp\u003eMultivariable analyses showed\u003c/p\u003e \u003cp\u003e- OPAT-clinic versus S-OPAT: OR 2.1, 95%CI 1.03\u0026ndash;2.28, p\u0026thinsp;=\u0026thinsp;0.02.\u003c/p\u003e \u003cp\u003e- OPAT-community nurse versus S-OPAT, NS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eS-OPAT-related adverse events (drug-related, line-related)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eS-OPAT-related adverse events 16/252 (6.3%)\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKieran, 2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClinical cure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52/56 patients (93%)\u003c/p\u003e \u003cp\u003eDifferences between S-OPAT and OPAT, NS No further information provided.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Readmissions related to S-OPAT\u003c/p\u003e \u003cp\u003e- AEs (line-related complications, drug-rel.ated adverse events\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Readmissions: 5/60 (8%)\u003c/p\u003e \u003cp\u003e- Line-related complications 5/60 (8%)\u003c/p\u003e \u003cp\u003e- Drug-related adverse events 4/60 (7%)\u003c/p\u003e \u003cp\u003eDifferences between S-OPAT and OPAT, NS. No further information provided.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMatthews, 2007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Complication rate (side effects or intolerance of drugs, complications related to vascular access device)\u003c/p\u003e \u003cp\u003e- Readmissions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eS-OPAT versus OPAT\u003c/p\u003e \u003cp\u003e- Complication rate: 112/473 (24%) versus 353/1536 (23%), NS\u003c/p\u003e \u003cp\u003e- Readmissions 50/473 (10.5%) versus 193/1536 (10.5%), NS\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePonce Gonzalez, 2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEffective treatment (absence of medical complications, absence of signs of acute disease, no ER visits, no readmissions, return to basal clinical situation)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e93.4%\u003c/p\u003e \u003cp\u003eUnivariable analysis showed no differences between\u003c/p\u003e \u003cp\u003eS-OPAT and OPAT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Adverse drug events\u003c/p\u003e \u003cp\u003e- Catheter-related complications\u003c/p\u003e \u003cp\u003e- Infection-related complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Adverse drug events: 2.3%\u003c/p\u003e \u003cp\u003e- Catheter-related complications: 2.7%\u003c/p\u003e \u003cp\u003e- Infection-related complications: 5.7%\u003c/p\u003e \u003cp\u003eUnivariable analysis showed no differences between\u003c/p\u003e \u003cp\u003eS-OPAT and OPAT\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSanroma, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCure or improvement (resolution or partial resolution of symptoms)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMultivariable analysis showed a non-significant association of S-OPAT with risk of treatment failure/relapse compared to OPAT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- S-OPAT related readmissions\u003c/p\u003e \u003cp\u003e- Death\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Readmissions: 15/371 (4%)\u003c/p\u003e \u003cp\u003e- Death: 13/371 (3.5%)\u003c/p\u003e \u003cp\u003eMultivariable analysis showed a non-significant association of S-OPAT with safety outcomes compared to OPAT\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSeetoh, 2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClinical deterioration (worsened co-morbidity or worsened infectious disease for which OPAT was initiated, leading to unplanned re-admission or death)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.6%\u003c/p\u003e \u003cp\u003eMultivariable analysis showed no differences between S-OPAT and OPAT, NS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- NR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- NR\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSriskandarajah, 2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCompletion of treatment as prescribed by pediatrician\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eS-OPAT: 86/100 (86%)\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Unplanned readmission\u003c/p\u003e \u003cp\u003e- AEs related to vascular access device\u003c/p\u003e \u003cp\u003e- AEs related to infusion device\u003c/p\u003e \u003cp\u003e- AEs related to antimicrobials\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Readmission: 8/100 (8%)\u003c/p\u003e \u003cp\u003e- AEs vascular access device: 16/100 (16%)\u003c/p\u003e \u003cp\u003e- AEs infusion device: 4/100 (4%)\u003c/p\u003e \u003cp\u003e- AEs antimicrobials: 0\u003c/p\u003e \u003cp\u003eAdjusted for covariates, S-OPAT was significantly associated with adverse events versus OPAT: OR 6.25, 95%CI 1.44-27,15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnderwood, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCatheter-related adverse events\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Adverse events: 8 (27%) or 12 (95%CI 6.0-23.9)/1000 catheter-days\u003c/p\u003e \u003cp\u003eAdjusted Poison regression analysis showed S-OPAT was associated with a higher rate of catheter-related adverse events compared OPAT: HR 4.15, 95%CI 1.7\u0026ndash;9.1, p\u0026thinsp;=\u0026thinsp;0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eDescriptive studies\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAkar, 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAntibiotic \u0026ndash; organism mismatch (antibiotic resistant against the isolated organism, use of an antibiotic with a too broad or too small spectrum)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22/210 (10.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Mechanical complication (dislodgement, displacement, thrombosis, damage to the catheter)\u003c/p\u003e \u003cp\u003e- Antibiotic toxicity (neutropenia, hepatitis, colitis, rash)\u003c/p\u003e \u003cp\u003e- Catheter-associated bloodstream infection\u003c/p\u003e \u003cp\u003e- S-OPAT related ED visits or hospitalisations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Mechanical complications: 21/210 (10%)\u003c/p\u003e \u003cp\u003e- Antibiotic toxicity: 26/210 (12.4%)\u003c/p\u003e \u003cp\u003e- Catheter-associated bloodstream infections: 3/210 (2.6%)\u003c/p\u003e \u003cp\u003e- ED visits or hospitalisations: 20/210 (9.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBodycot, 2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e- Infection improved or cured.\u003c/p\u003e \u003cp\u003e- S-OPAT process successfull or partially successful\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e- Infection improved or cured:\u003c/p\u003e \u003cp\u003erange 84.6% \u0026minus;\u0026thinsp;92\u0026thinsp;\u0026minus;\u0026thinsp;8%\u003c/p\u003e \u003cp\u003e- S-OPAT (partially) successful:\u003c/p\u003e \u003cp\u003erange 75%- 91.4%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSerious vascular access device events (thrombus, catheter-related bloodstream infection)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Thrombus: 11/1084 (1%)\u003c/p\u003e \u003cp\u003e- Catheter-related bloodstream infection: 2/1084 (0.2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDubois-Silva, 2023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Catheter-related bloodstream infection\u003c/p\u003e \u003cp\u003e- Readmission due to vascular access complication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Catheter-related bloodstream infection: 0\u003c/p\u003e \u003cp\u003e- Readmission: 0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrieler, 2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSuccessful treatment (infection eradication, no subsequent surgical intervention after revision surgery, no infection-related mortality)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21/23 (91%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Adverse drug reactions\u003c/p\u003e \u003cp\u003e- Catheter-related complications\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Adverse drug reactions: 1/26 (2%)\u003c/p\u003e \u003cp\u003e- Catheter-related complications 5/54 (9%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGardiol, 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Catheter-related bloodstream infection (positive blood culture).\u003c/p\u003e \u003cp\u003e- OPAT-related readmission\u003c/p\u003e \u003cp\u003e- Mortality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Catheter-related bloodstream infection 1/55 (2%)\u003c/p\u003e \u003cp\u003e- OPAT-related readmission 2/55 (4%)\u003c/p\u003e \u003cp\u003e- Mortality 0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKarimaghael, 2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTreatment completion\u003c/p\u003e \u003cp\u003eCure from infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTreatment completion 83/91 (92.2%)\u003c/p\u003e \u003cp\u003eCure from infection 85/91 (93.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- 30-days readmission related to S-OPAT\u003c/p\u003e \u003cp\u003e- 30-days ED visits related to S-OPAT\u003c/p\u003e \u003cp\u003e- ED visits during and related to S-OPAT\u003c/p\u003e \u003cp\u003e- Central line-associated issues\u003c/p\u003e \u003cp\u003e- Antibiotics-related side effects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- 30-days readmission 1/91 (1.1%)\u003c/p\u003e \u003cp\u003e- 30-days ED visits 15/91 (16.5%)\u003c/p\u003e \u003cp\u003e- ED visits during S-OPAT 15/91 (16.5%)\u003c/p\u003e \u003cp\u003e- Central line-associated issues 13/91 (14.3%)\u003c/p\u003e \u003cp\u003e- Antibiotics-related side effects 6/91 (6.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKilinc, 2023 (a)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTreatment failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Adverse effects or complications regarding laboratory parameters\u003c/p\u003e \u003cp\u003e- PICC line complications\u003c/p\u003e \u003cp\u003e- Readmission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Adverse effects or complications 0\u003c/p\u003e \u003cp\u003e- PICC line complications 0\u003c/p\u003e \u003cp\u003e- Readmission 1/52 (2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKilinc, 2023 (b)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTreatment failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3/45 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Readmission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Readmission 5/45 (11.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLopez-Cortes, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResolution of the exacerbation (resolution of fever, resolution or reduction of purulent secretions, improvement of dyspnea, normalization of acute-phase reactants, and improvement of oxygen saturation levels)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63/67 (94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Readmission\u003c/p\u003e \u003cp\u003e- Mortality\u003c/p\u003e \u003cp\u003e- Nephrotoxicity\u003c/p\u003e \u003cp\u003e- Catheter-associated bacteremia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Readmission: 4/67 (6%)\u003c/p\u003e \u003cp\u003e- Mortality: 1 (2%)\u003c/p\u003e \u003cp\u003e- Nephrotoxicity: 2 (3%)\u003c/p\u003e \u003cp\u003e- Catheter-associated bacteremia: 0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonton, 2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSatisfactory clinical outcome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44/50 (87%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Readmission during S-OPAT\u003c/p\u003e \u003cp\u003e- Complications vascular access device\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Readmissions: 6/50 (13%)\u003c/p\u003e \u003cp\u003e- Complications:(minor): 15/50 (30%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePajaron, 2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRelapse of the infectious endocarditis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 patients (5.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Mortality\u003c/p\u003e \u003cp\u003e- Complications resolved home\u003c/p\u003e \u003cp\u003e- Unexpected readmissions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Mortality: 0\u003c/p\u003e \u003cp\u003e- Complications: 11/57 (19.2%)\u003c/p\u003e \u003cp\u003e- Readmissions: 6/57 (10.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSchmidt-Hellerau, 2024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCuration or switch to oral antibiotic treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70/74 (95%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Missed administrations more than 1\u003c/p\u003e \u003cp\u003e- All-cause readmissions\u003c/p\u003e \u003cp\u003e- S-OPAT related readmission\u003c/p\u003e \u003cp\u003e- Severe catheter-related AEs (CTCAE grade 3 and 4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Missed administrations: 4/77 (5%)\u003c/p\u003e \u003cp\u003e- All-cause readmissions: 16/77 (21%)\u003c/p\u003e \u003cp\u003e- S-OPAT related readmission: 1/77 (1%)\u003c/p\u003e \u003cp\u003e- Catheter-related AEs: 4/77 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eZikri, 2021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRelaps of infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6/47 (12.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- ED visits S-OPAT related\u003c/p\u003e \u003cp\u003e- Readmissions S-OPAT related\u003c/p\u003e \u003cp\u003e- Mortality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- ED visits: 42/47 (89%)\u003c/p\u003e \u003cp\u003e- Readmissions: 4/47 (8.5%)\u003c/p\u003e \u003cp\u003e- Mortality: 0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAE: Adverse Event; CTCAE: Common Terminology for Adverse Events; ED: Emergency Department; HR: Hazard Ratio; OR: Odds Ratio; NR: not reported; NS: not statistically significant; 95%CI: 95% confidence interval; aIRR: adjusted incidence rate ratio\u003c/p\u003e \u003cp\u003e \u003csup\u003e1\u003c/sup\u003e Results only descriptively reported.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eFactors impacting S-OPAT clinical outcome and safety\u003c/h2\u003e \u003cp\u003eA summary of the factors impacting S-OPAT clinical outcome and safety as reported in the included studies is presented in Table\u0026nbsp;3. Seven potential risk factors were studied in 9 studies: age [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e], drug use [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e], comorbidity [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], microbiological diagnosis [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], antimicrobial agent [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e], catheter type [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], and delivery method [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Patients with two or more comorbidities had an increased risk of treatment failure [\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e], and diabetes resulted in an increased risk of relapse at 90 days post treatment [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. \u003cem\u003eStaphylococcus aureus\u003c/em\u003e infections were associated with an increased rate of catheter complications [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Older age increased the risk of nephrotoxicity [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e], and readmission rates due to worsening of underlying diseases [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. Some studies looked at individual antimicrobial agents in detail and found that cefazolin, vancomycin and daptomycin were associated with more catheter complications [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Lee et al. reported that antibiotic switches for adverse events were more frequent with oxacillin use [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Midline catheters were associated with an increased rate of catheter complications [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. However, drip infusion or prefilled syringe delivery methods did not influence safety [\u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFactors impacting S-OPAT clinical outcome and safety\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFactor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAuthor, date\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eClinical outcomes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eSafety\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDefinition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eResults\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eDefinitions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eResults\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCox, 2007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFailure of treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Group age\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;60 y. versus group age\u0026thinsp;\u0026lt;\u0026thinsp;60 y.: 9 (8%) versus 7 (6%), NS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Allergic reactions (rash, urticaria, anaphylaxis), nephrotoxicity, leucopenia, neutropenia, thrombocytopenia, eosinophilia\u003c/p\u003e \u003cp\u003e- Venous access device complications (deep venous thrombosis, phlebitis, accidental removal of device, leaking, local infection and device-related bloodstream infection)\u003c/p\u003e \u003cp\u003e- Hospital readmission\u003c/p\u003e \u003cp\u003e- Urgent care visit related to S-OPAT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eResults/1000 home iv days, group age\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;60 y. versus group age\u0026thinsp;\u0026lt;\u0026thinsp;60 y.\u003c/p\u003e \u003cp\u003e- Nephrotoxicity: 3.03 versus 0.46, p\u0026thinsp;=\u0026thinsp;0.02\u003c/p\u003e \u003cp\u003e- Urgent visits: 31.4 versus 14.3, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003cp\u003e- Other outcomes, NS\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMujal, 2016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInadequate control of infection leading to antibiotic switch, readmissions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGroup\u0026thinsp;\u0026lt;\u0026thinsp;60 y. versus Group 65\u0026ndash;79 y. versus Group\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;80 y.: 29 (21%) versus 17 (9%) versus 18 (18%), NS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Adverse drug events\u003c/p\u003e \u003cp\u003e- Catheter-related complications\u003c/p\u003e \u003cp\u003e- Readmission\u0026thinsp;\u0026lt;\u0026thinsp;30 days after discharge all cause\u003c/p\u003e \u003cp\u003e- Readmission due to worsening of underlying diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eGroup\u0026thinsp;\u0026lt;\u0026thinsp;60 y. versus Group 65\u0026ndash;79 y. versus Group\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;80 y. (corrected for confounders):\u003c/p\u003e \u003cp\u003e- Adverse drug events: 7 (5%) versus 5 (2.7%) versus 3 (3%), NS\u003c/p\u003e \u003cp\u003e- Catheter-related complications: 22 (15.8%) versus 32 (17.6%) versus 20 (20.2%), NS\u003c/p\u003e \u003cp\u003e- Readmission\u0026thinsp;\u0026lt;\u0026thinsp;30 days after discharge all cause: 27 (19.4%) versus 47 (25.8%) versus 27 (27.3%), NS\u003c/p\u003e \u003cp\u003e- Readmission due to worsening of underlying diseases: 15 (10.8%) versus 38 (20.9%) versus 19 (19.2%), p\u0026thinsp;=\u0026thinsp;0.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eComorbidity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMohammadi, 2013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOverall clinical cure at end of treatment and 90-days post S-OPAT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAt end of treatment\u003c/p\u003e \u003cp\u003e148 (78%)\u003c/p\u003e \u003cp\u003e90-days post S-OPAT\u003c/p\u003e \u003cp\u003e110 (58%)\u003c/p\u003e \u003cp\u003eAfter corrected for infection type, patients with diabetes had an increased risk of relapse at 90 days post S-OPAT: OR 1.76, 95%CI 1.57\u0026ndash;196, p\u0026thinsp;=\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- AEs (neutropenia, diarrhea, rash, nephrotoxicity)\u003c/p\u003e \u003cp\u003e- Complications related to vascular access device\u003c/p\u003e \u003cp\u003e- Readmissions\u003c/p\u003e \u003cp\u003e- ED visits\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e- AEs: 12 (6.3%)\u003c/p\u003e \u003cp\u003e- Vascular access device complications: 5 (2.6%)\u003c/p\u003e \u003cp\u003e- Readmissions 3 (1.6%)\u003c/p\u003e \u003cp\u003e- ED visits 2 (1.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSubedi, 2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTreatment success (cure or major improvement, decrease in C-reactive protein, no relapse within 28 days after end of treatment)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93%\u003c/p\u003e \u003cp\u003eMultivariate analysis showed patients with 2 or more comorbidities had an increased risk of treatment failure: OR 2.15, 95%CI 1.28\u0026ndash;3.65, p\u0026thinsp;=\u0026thinsp;0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Drug-related complications (e.g. rash, hepatitis, gastrointestinal symptoms)\u003c/p\u003e \u003cp\u003e- Line-related complications (line infection, thrombosis, leakage, accidental removal)\u003c/p\u003e \u003cp\u003e- Readmissions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e- Drug-related: 11 (7%)\u003c/p\u003e \u003cp\u003e- Line-related: 5 (3%) or 1.4/1000 catheter-days\u003c/p\u003e \u003cp\u003e- Readmissions 9 (6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDrug use\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAppa, 2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTreatment completion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDrug use versus no drug use:\u003c/p\u003e \u003cp\u003e91% versus 89%, NS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Hospital readmissions (30-days and 90-days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eDrug use versus no drug use:\u003c/p\u003e \u003cp\u003e- 30-days 3 versus 0, NS\u003c/p\u003e \u003cp\u003e- 90-days 3 versus 2, NS\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMicro-biological diagnosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKeller, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Catheter complications (occlusion, thrombosis, extravasation, phlebitis)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e- Patients: 43 (12.7%)\u003c/p\u003e \u003cp\u003e- 2.62/1000 OPAT days\u003c/p\u003e \u003cp\u003eFactor associated with catheter complications:\u003c/p\u003e \u003cp\u003e- Staphylococcus aureus infection (aIRR 2.13, 95%CI 1.09\u0026ndash;4.19)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eAntimicrobial agent\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGanguly, 2023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTreatment failure (repeat positive blood culture or retreatment within 6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCefazolin versus Ceftriaxone:\u003c/p\u003e \u003cp\u003e10 (4%) versus 2 (2%), NS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- 30-days all-cause readmission rate\u003c/p\u003e \u003cp\u003e- Central line-associated bloodstream infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCefazolin versus Ceftriaxone:\u003c/p\u003e \u003cp\u003e- Readmission rate 62 (22%) versus 17 (21%), NS\u003c/p\u003e \u003cp\u003e- Central line-associated bloodstream infection 31 (11%) versus 2 (2%), p\u0026thinsp;=\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKeller, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Catheter complications (occlusion, thrombosis, extravasation, phlebitis)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAssociated with catheter complications:\u003c/p\u003e \u003cp\u003e- Daptomycin (aIRR 4.45, 95%CI 1.02\u0026ndash;19.41)\u003c/p\u003e \u003cp\u003e- Vancomycin (aIRR 2.32, 95%CI 1.20\u0026ndash;4.46)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLee, 2015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eClinical cure (resolution of signs and symptoms of infection and discontinuation of antibiotic therapy)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal 287 (72%)\u003c/p\u003e \u003cp\u003eAfter correction for confounding:\u003c/p\u003e \u003cp\u003eoxacillin showed a lower treatment success rate (HR 0.53, 95%CI 0.39\u0026ndash;0.74) compared to ertapenem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Adverse drug reaction (diarrhea, fever, transaminitis, neutropenia, rash, acute renal injury)\u003c/p\u003e \u003cp\u003e- Outpatient antibiotic switch\u003c/p\u003e \u003cp\u003e- Readmissions within 30 days\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e- Adverse drug reaction: 47 (11.6%)\u003c/p\u003e \u003cp\u003e- Outpatient antibiotic switch: 50 (12.5%)\u003c/p\u003e \u003cp\u003e- Readmissions: 67 (16.8%)\u003c/p\u003e \u003cp\u003eAfter correction for confounding:\u003c/p\u003e \u003cp\u003eoxacillin showed higher antibiotic switches due to adverse drug reactions or treatment failure (HR 5.06, 95%CI 1.74\u0026ndash;14.75) compared to ertapenem.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCatheter type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKeller, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Catheter complications (occlusion, thrombosis, extravasation, phlebitis)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e- Patients: 43 (12.7%)\u003c/p\u003e \u003cp\u003e- 2.62/1000 OPAT days\u003c/p\u003e \u003cp\u003eFactor associated with catheter complications:\u003c/p\u003e \u003cp\u003e- Midlines (aIRR 9.44, 95%CI 1.12\u0026ndash;41.97)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDelivery method\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYagnik, 2022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- All cause 30-days readmissions\u003c/p\u003e \u003cp\u003e- All cause 1-year readmissions\u003c/p\u003e \u003cp\u003e- ED visits within 30 days\u003c/p\u003e \u003cp\u003e- ED visits within 1 year\u003c/p\u003e \u003cp\u003e- Mortality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e- 30-days readmissions: 21 (11%)\u003c/p\u003e \u003cp\u003e- 1-year readmissions: 66 (33%)\u003c/p\u003e \u003cp\u003e- ED visits 30 days: 46 (23%)\u003c/p\u003e \u003cp\u003e- ED visits 1 year: 87 (44%)\u003c/p\u003e \u003cp\u003e- Mortality: 11 (5%)\u003c/p\u003e \u003cp\u003eThere were no significant differences between the drip infusion and prefilled syringe delivery method.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAE: Adverse Event; ED: Emergency Department; HR: Hazard Ratio; OR: Odds Ratio; NS: not statistically significant; 95%CI: 95% confidence interval; aIRR: adjusted incidence rate ratio\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003ePatient-centred outcomes\u003c/h2\u003e \u003cp\u003eA summary of the patients-centred outcomes is presented in Table\u0026nbsp;4. We found 14 publications reporting on patient-centered outcomes [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan additionalcitationids=\"CR29 CR30 CR31 CR32 CR33 CR34\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Seven studies explored patient-centred outcomes as secondary research objectives [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan additionalcitationids=\"CR33 CR34\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. S-OPAT compared to OPAT showed more favorable outcomes for S-OPAT [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e]. S-OPAT compared to oral antibiotics showed better patient-centred outcomes for oral antibiotics [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Over 90% of the participants preferred antibiotic treatment at home rather than in hospital [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e], and satisfaction with S-OPAT was high [\u003cspan additionalcitationids=\"CR32 CR33\" citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. At discharge and during the S-OPAT period patients and caregivers were comfortable with S-OPAT [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e], and the burden for caregivers of pediatric patients seemed acceptable [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Two studies report high levels of competency of patients and caregivers after S-OPAT training [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e51\u003c/span\u003e]. Besides the positive results, barriers with S-OPAT, such as restricted mobility and infection prevention, are reported as well [\u003cspan additionalcitationids=\"CR29\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePatients- and caregivers-centred outcomes\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAuthor, date\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eParticipants\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSample size\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eData collection\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eResults\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eComparative studies\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKrah, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePediatric patients and their caregivers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e- Self-constructed survey exploring comfort with the S-OPAT process and burden of administration (5-point Likert scale)\u003c/p\u003e \u003cp\u003e- Family impact module Paediatric Quality of Life Inventory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eComparison between oral treatment versus S-OPAT:\u003c/p\u003e \u003cp\u003e- Comfort with the treatment at discharge: mean 2.87 (SD 1.51) versus 2.09 (SD 1.46), p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003cp\u003e- Comfort with the treatment at follow-up: mean 3.02 (SD 1.59) versus 2.82 (SD 1.61), NS\u003c/p\u003e \u003cp\u003e- Burden of drug administration caregiver: mean 0.64 (SD 0.84) versus 1.30 (SD 1.11), p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003cp\u003e- Burden of drug administration patient: mean 1.04 (SD 1.15) versus 1.38 (SD 1.14), NS\u003c/p\u003e \u003cp\u003e- Burden laboratory tests: mean 1.87 (SD 1.31) versus 1.04 (SD 1.17), p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003cp\u003eAfter correction for baseline differences, QoL in the S-OPAT group was significantly lower than in the oral antibiotic group: difference 8.3 points, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSaillen, 2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSurvey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- S-OPAT patients scored significantly better (after adjustment for age, sex and treatment duration) on 6/17 questions, compared to OPAT patients\u003c/p\u003e \u003cp\u003e- Overall satisfaction was statistically higher in S-OPAT patients compared to OPAT patients: 96% versus 80% (OR 5.0, 95%CI 1.19-20.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eDescriptive studies\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBodycot, 2020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSelf-constructed questionnaire\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePreference for AB treatment at home: 29/32 (90.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEaves, 2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients and caregivers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePatients 29 Caregivers 9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eReassessment of competence by specialist nurse.\u003c/p\u003e \u003cp\u003eMedian interval between completion of initial training and reassessment: 35 d. (range 12\u0026ndash;118)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Fully competent: 35/38 (92%)\u003c/p\u003e \u003cp\u003e- Patient made a mistake with immediate correction: 2/38 (5%)\u003c/p\u003e \u003cp\u003e- Patient made a mistake and continued with the procedure: 1/38 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeller, 2022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSurvey at least 2 weeks after discharge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Comfortable infusing medication at discharge: 18/20 (90%)\u003c/p\u003e \u003cp\u003e- Comfortable infusing medication 2 weeks after discharge: 20/20 (100%)\u003c/p\u003e \u003cp\u003e- Comfortable with bathing with the IV catheter: 16/20 (80%)\u003c/p\u003e \u003cp\u003e- Satisfaction with the training: 19/20 (95%)\u003c/p\u003e \u003cp\u003e- Satisfaction with managing the IV catheter at home: 20/20 (100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKieran, 2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStandardized telephone survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Preference for AB treatment at home 12/12 (100%)\u003c/p\u003e \u003cp\u003e- Satisfaction with the service and the instructions 12/12 (100%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKilinc, 2023 (a)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSelf-constructed survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Satisfaction with S-OPAT: 51/52 (98.1%)\u003c/p\u003e \u003cp\u003e- No problem managing S-OPAT at home: 43/52 (82.7%)\u003c/p\u003e \u003cp\u003e- Ability to carry out tasks at home: 35/52 (67.3%)\u003c/p\u003e \u003cp\u003e- Ability to return to work: 16/52 (30.8%)\u003c/p\u003e \u003cp\u003e- Self-perceived good health: 48/52 (92.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKilinc, 2023 (b)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSelf-constructed survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Satisfaction with S-OPAT: 28/33 (84.8%)\u003c/p\u003e \u003cp\u003e- Ability to carry out tasks at home: 19/33 (57.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLopez-Cortes, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSurvey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Preference for AB treatment at home: 66/67 (99%)\u003c/p\u003e \u003cp\u003e- Significant improvement in quality of life: 39/45 (86.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYagnik, 2022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCompetency 200 Survey 22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCompetency assessment by teach-back method\u003c/p\u003e \u003cp\u003eSatisfaction survey\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Competency: 82% achieved acceptable level in \u0026le;\u0026thinsp;3 attemps\u003c/p\u003e \u003cp\u003e- Satisfaction survey: 96% of participating patients chose the syringe method over the IV drip\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eQualitative studies\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeller, 2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInterviews 29 Observations 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSemi-structured interviews.\u003c/p\u003e \u003cp\u003eContextual inquiry tools for the observations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHazards related to physical attributes in patients\u0026rsquo; home environments:\u003c/p\u003e \u003cp\u003e- Unclear how to bath with catheter\u003c/p\u003e \u003cp\u003e- Pets shed fur, create waste and tug on catheter\u003c/p\u003e \u003cp\u003e- Extremes in temperature (warm and cold)\u003c/p\u003e \u003cp\u003e- Household clutter, e.g. patients cannot access certain parts of the home\u003c/p\u003e \u003cp\u003e- Indoor soil and food, e.g. physical state makes it difficult to perform household tasks\u003c/p\u003e \u003cp\u003e- Outdoor work: exposed to soil or dirt\u003c/p\u003e \u003cp\u003e- Travel, e.g. patient must carry supplies and perform tasks outside of the home\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeller, 2020 (a)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients and caregivers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePatients 7\u003c/p\u003e \u003cp\u003eCaregivers 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFocus group discussions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBarriers most frequently mentioned:\u003c/p\u003e \u003cp\u003e- Healthcare professionals may not always with each other about the patient's care\u003c/p\u003e \u003cp\u003e- Instruction is rushed\u003c/p\u003e \u003cp\u003e- Uncertainty how to bath with a catheter\u003c/p\u003e \u003cp\u003e- Patients and caregivers must devote a lot of time for S-OPAT tasks\u003c/p\u003e \u003cp\u003e- The catheter gets caught as the patient moves around the house\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKeller, 2020 (b)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInterviews 40 Observations 20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSemi-structured interviews\u003c/p\u003e \u003cp\u003eContextual inquiry tools for the observations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Patients appreciate visual cognitive aids to remember (sub)tasks\u003c/p\u003e \u003cp\u003e- Patients struggle to understand instructions\u003c/p\u003e \u003cp\u003e- Patients are uncertain about several instructions, e.g. hand washing, the temperature of the medication\u003c/p\u003e \u003cp\u003e- Patients struggle to detect incidents, and do not always respond to alerts\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTwiddy, 2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdult patients\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePatients 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSemi-structured interviews\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e- Multiple treatments each day left the patients with little time to fit anything else into the day\u003c/p\u003e \u003cp\u003e- Maintaining aseptic technique, correct storage of medication and administering the drugs became routine for patients, but all were aware of the consequences of any lapse of judgement. Reminders by nurses were appreciated\u003c/p\u003e \u003cp\u003e- Formal training and ongoing support by nurses were considered essential and enabled them to be fully involved in decisions about their care\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003e This scoping review aimed to give a comprehensive overview of publications reporting on the clinical outcomes and safety of S-OPAT, factors impacting these outcomes, and experiences of patients and caregivers with S-OPAT. After systematically searching the literature of the past 17 years, a total of 44 studies were included in this review. Clinical outcomes were reported in 17 and safety in 23 publications. Many publications were descriptive and reported on the evaluation of S-OPAT care in a single cohort. Eleven studies compared S-OPAT to other OPAT delivery models. These studies showed that clinical outcomes were generally comparable. Two studies found increased adverse events with S-OPAT, while the majority reported no safety concerns. Seven potential risk factors were explored in 9 studies: age, drug use, comorbidity, microbiological diagnosis, antimicrobial agent, catheter type, and delivery method. Risk factors for adverse events included older age, comorbidities and \u003cem\u003estaphylococcus aureus\u003c/em\u003e infection. Fourteen studies reported on patient-centred outcomes and showed that patients and caregivers considered S-OPAT a suitable alternative for other OPAT delivery models.\u003c/p\u003e \u003cp\u003eHealthcare systems will face substantial challenges in the coming decades. The aging population and the expected increase in chronic and acute diseases will result in a growing care demand. To ensure the availability, quality and affordability of care, efforts will need to be made to reduce unnecessary hospital stays and to increase the reliance on informal care. It is expected that patients will become increasingly dependent on family support [\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e]. This development also affects OPAT care, highlighting the urgent need for the implementation of an S-OPAT pathway. The studies in our review suggest that S-OPAT is an acceptable healthcare model for suitable patients. As safety is the main concern, healthcare professionals should anticipate preparing patients and family members during admission for the period after discharge to guarantee safety and optimal clinical outcome [\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWe identified a substantial degree of heterogeneity in the included studies. We observed substantial variation in patient populations, infectious disease diagnoses, and treatment characteristics (e.g., choice of antimicrobial agents or catheter type). Also, the varying comparators used in the comparative studies of S-OPAT makes it difficult to draw overarching conclusions. For example, OPAT care might be delivered by a community nurse at the patients\u0026rsquo; homes, or within a specialized clinic or infusion centre, where patients attend an OPAT facility daily [\u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e55\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMoreover, the definitions of clinical outcome and safety differed across studies. For example, clinical outcome was reported as treatment success, cure, improvement or deterioration, and safety was recorded as drug-related adverse events, catheter complications, readmissions or mortality. These inconsistencies in outcome reporting make it impossible to make meaningful comparisons between studies, thereby hindering the ability to reach firm conclusions as previously noted [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e, \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e]. To overcome this problem, the development of a core outcome set (COS) for research on OPAT delivery models might contribute to more consistency, making it easier for study results to be compared and combined as appropriate [\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e], and implemented [\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e]. This scoping review could be the first step, but obviously more work needs to be done, i.e. patient and caregiver consultation to identify the outcomes they consider relevant, and a Delphi study to reach consensus among experts. The previously developed set of quality indicators to assess and improve the quality of OPAT care may be helpful to move forward in this field [\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCareful patient selection is considered crucial to guarantee a successful S-OPAT clinical pathway [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Selection criteria for OPAT are well described [\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e], but additional criteria are needed for S-OPAT. As self-administration is the key difference compared to OPAT delivery models, the additional criteria should focus on training and self-management skills, compliance of patients, the role of caregivers, and the safety and suitability of the home environment. The included studies in this review describing risk factors for adverse events during S-OPAT, did not describe these factors specifically related to S-OPAT.\u003c/p\u003e \u003cp\u003ePrevious studies have found positive associations between patients\u0026rsquo; and caregivers\u0026rsquo; experiences and clinical outcome and safety among a wide range of health conditions [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e, \u003cspan citationid=\"CR63\" class=\"CitationRef\"\u003e63\u003c/span\u003e]. However, we found that only few of the clinical studies included in this review described patient-centred outcomes of S-OPAT. The experiences of caregivers were explored even less. Furthermore, constructs explored varied (e.g., satisfaction, comfort, experiences, self-efficacy) and were mainly measured with self-constructed questionnaires. As one of the main reasons to initiated S-OPAT is to improve the quality of life for both patients and caregivers [\u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e64\u003c/span\u003e], this outcome measure deserves additional attention. Validated tools are available, such as EQ-5D-5L [\u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e65\u003c/span\u003e] and CarerQoL-7D [\u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e66\u003c/span\u003e]. Also, confidence in managing health issues, and experienced burden are considered important outcome measures with the increasing involvement of patients and families in healthcare [\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e]. Again, these outcomes can be assessed using validated tools, such as the Health Confidence Score (HCS) [\u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e67\u003c/span\u003e], and the Caregiver Strain Index plus (CSI+) [\u003cspan citationid=\"CR68\" class=\"CitationRef\"\u003e68\u003c/span\u003e]. In addition, qualitative studies are valuable to obtain more in-depth information. Measuring patient reported outcome measures should be integrated in the S-OPAT pathway to provide optimal support for both patients and caregivers [\u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e69\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e This scoping review has strengths and limitations. Firstly, we followed the preferred methodology of executing and reporting a scoping review and retrieved relevant articles using 4 distinct databases: MEDLINE, CINAHL, Embase and Cochrane library. Secondly, we studied nearly all studies full text as OPAT and S-OPAT are terms often used interchangeable. However, we limited the search to the past 17 years which may have resulted in missing publications published before that timeframe. However, older publications are less representative of the current state of S-OPAT literature, which we aimed to describe. In addition, we did not report on the level of evidence of the included studies. Performing critical appraisal was beyond the aim of this scoping review and is not required in the JBI methodology for scoping reviews. This means that this review provides a description of relevant publications to inform clinical practice on S-OPAT and does not attempt to draw conclusions based on their results.\u003c/p\u003e \u003cp\u003eBesides the above-mentioned directions for future research, the role of artificial intelligence should be explored as an innovative approach to predict clinical outcome and safety for OPAT patients in different delivery models [\u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e70\u003c/span\u003e]. Another important research topic is the ecological footprint that comes with antimicrobial treatment and the different delivery models. It is widely recognized that healthcare has a large climate impact [\u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e71\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eBased on the gaps of knowledge, we started research projects to investigate factors that contribute to successful S-OPAT care, experiences of patients and their caregivers, as well as the ecological footprint of different OPAT models.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis scoping review identified studies on S-OPAT with considerable variation in outcome measures, and a notable lack of research on patients and caregivers experiences. The growing care demand now and in the future urges further development of S-OPAT care. Recommendations for future research are formulated. Attention should be paid to robust study methodology and reporting, promoting homogeneity in outcome measures.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJM: Conceptualisation, Methodology, Data collection, Synthesis, Writing - original draftTS: Methodology, Data collection, Synthesis, Writing - review and editingLV: Methodology, Data collection,FvE: Methodology, Data collectionSG: Conceptualisation, Writing - review and editingKS: Conceptualisation, Methodology, Synthesis, Writing - review and editing\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eNorris AH, Shrestha NK, Allison GM, Keller SC, Bhavan KP, Zurlo JJ, et al. 2018 Infectious Diseases Society of America Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy. Clin Infect Dis. 2019;68(1):1\u0026ndash;4. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/cid/ciy867\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/cid/ciy867\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBellamy R. Outpatient parenteral antimicrobial therapy. Br J Hosp Med (Lond). 2018;79(1):12\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.12968/hmed.2018.79.1.12\u003c/span\u003e\u003cspan address=\"10.12968/hmed.2018.79.1.12\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://\u003c/span\u003e\u003cspan address=\"https://\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWilliams DN, Baker CA, Kind AC, Sannes MR. The history and evolution of outpatient parenteral antibiotic therapy (OPAT). Int J Antimicrob Agents. 2015;46(3):307\u0026ndash;12. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ijantimicag.2015.07.001\u003c/span\u003e\u003cspan address=\"10.1016/j.ijantimicag.2015.07.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohammed SA, Roberts JA, Cotta MO, Rogers B, Pollard J, Assefa GM, et al. Safety and efficacy of outpatient parenteral antimicrobial therapy: A systematic review and meta-analysis of randomized clinical trials. Int J Antimicrob Agents. 2024;64(2):107263. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.ijantimicag.2024.107263\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.ijantimicag.2024.107263\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMatthews PC, Conlon CP, Berendt AR, Kayley J, Jefferies L, Atkins BL, et al. Outpatient parenteral antimicrobial therapy (OPAT): is it safe for selected patients to self-administer at home? A retrospective analysis of a large cohort over 13 years. J Antimicrob Chemother. 2007;60(2):356\u0026ndash;62. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/jac/dkm210\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/jac/dkm210\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAntoniskis A, Anderson BC, Van Volkinburg EJ, Jackson JM, Gilbert DN. Feasibility of outpatient self-administration of parenteral antibiotics. West J Med. 1978;128(3):203\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEmilie C, de Nocker P, Sa\u0026iuml;dani N, Gilchrist M, Seaton RA, Patel S, ESGAP-BSAC OPAT Survey Working Group, et al. Survey of delivery of parenteral antimicrobials in non-inpatient settings across Europe. Int J Antimicrob Agents. 2022;59(4):106559. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.ijantimicag.2022.106559\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.ijantimicag.2022.106559\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMitchell ED, Czoski Murray C, Meads D, Minton J, Wright J, Twiddy M. Clinical and cost-effectiveness, safety and acceptability of \u003cem\u003ec\u003c/em\u003eommunity \u003cem\u003ei\u003c/em\u003entra\u003cem\u003ev\u003c/em\u003eenous \u003cem\u003ea\u003c/em\u003entibiotic \u003cem\u003es\u003c/em\u003eervice models: CIVAS systematic review. BMJ Open. 2017;7(4):e013560. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1136/bmjopen-2016-013560\u003c/span\u003e\u003cspan address=\"https://doi:10.1136/bmjopen-2016-013560\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis. JBI; 2024. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://synthesismanual.jbi.global\u003c/span\u003e\u003cspan address=\"https://synthesismanual.jbi.global\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Assessed: September 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467\u0026ndash;73. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.7326/M18-0850\u003c/span\u003e\u003cspan address=\"https://doi:10.7326/M18-0850\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePeters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020;18(10):2119\u0026ndash;26. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.11124/JBIES-20-00167\u003c/span\u003e\u003cspan address=\"https://doi:10.11124/JBIES-20-00167\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAkar A, Singh N, Hyun DY. Appropriateness and safety of outpatient parenteral antimicrobial therapy in children: opportunities for pediatric antimicrobial stewardship. Clin Pediatr (Phila). 2014;53(10):1000\u0026ndash;3. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1177/0009922813507999\u003c/span\u003e\u003cspan address=\"https://doi:10.1177/0009922813507999\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAppa A, Marquez C, Jain V. Home-Based Outpatient Parenteral Antibiotic Therapy at an Urban Safety Net Hospital: Comparing Outcomes in Persons with and Without Noninjection Drug Use. Open Forum Infect Dis. 2020;7(5):ofaa162. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/ofid/ofaa162\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/ofid/ofaa162\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBalaguer A, Gonz\u0026aacute;lez de Dios J. Home versus hospital intravenous antibiotic therapy for cystic fibrosis. Cochrane Database Syst Rev. 2015;2015(12):CD001917. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1002/14651858.CD001917.pub4\u003c/span\u003e\u003cspan address=\"https://doi:10.1002/14651858.CD001917.pub4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarr DA, Semple L, Seaton RA. Self-administration of outpatient parenteral antibiotic therapy and risk of catheter-related adverse events: a retrospective cohort study. Eur J Clin Microbiol Infect Dis. 2012;31(10):2611\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1007/s10096-012-1604-z\u003c/span\u003e\u003cspan address=\"https://doi:10.1007/s10096-012-1604-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBhavan KP, Brown LS, Haley RW. Self-Administered Outpatient Antimicrobial Infusion by Uninsured Patients Discharged from a Safety-Net Hospital: A Propensity-Score-Balanced Retrospective Cohort Study. PLoS Med. 2015;12(12):e1001922. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1371/journal.pmed.1001922\u003c/span\u003e\u003cspan address=\"https://doi:10.1371/journal.pmed.1001922\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBodycot J, Mashonganyika L, Kucziw N, Ingham C, Bhukera S, White HA. Maximising the opportunity of a self-administration outpatient parenteral antimicrobial therapy pathway. Br J Nurs. 2021;30(2):S4\u0026ndash;10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.12968/bjon.2021.30.2.S4\u003c/span\u003e\u003cspan address=\"https://doi:10.12968/bjon.2021.30.2.S4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCox AM, Malani PN, Wiseman SW, Kauffman CA. Home intravenous antimicrobial infusion therapy: a viable option in older adults. J Am Geriatr Soc. 2007;55(5):645\u0026ndash;50. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1111/j.1532-5415.2007.01133.x\u003c/span\u003e\u003cspan address=\"https://doi:10.1111/j.1532-5415.2007.01133.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDubois-Silva \u0026Aacute;, Otero-Plaza L, Dopico-Santamari\u0026ntilde;a L, Mozo-R\u0026iacute;os A, Hermida-Porto L, Feal-Cortizas B, et al. Outpatient parenteral antimicrobial therapy with continuous infusion of meropenem: A retrospective analysis of three years of clinical experience. Enferm Infecc Microbiol Clin (Engl Ed). 2023;41(6):321\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.eimce.2021.11.012\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.eimce.2021.11.012\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDurojaiye OC, Kritsotakis EI, Johnston P, Kenny T, Ntziora F, Cartwright K. Developing a risk prediction model for 30-day unplanned hospitalization in patients receiving outpatient parenteral antimicrobial therapy. Clin Microbiol Infect. 2019;25(7):905. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.cmi.2018.11.009\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.cmi.2018.11.009\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e.e1-905.e7\u003c/span\u003e\u003cspan address=\"http://.e1-905.e7\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEaves K, Thornton J, Chapman AL. Patient retention of training in self-administration of intravenous antibiotic therapy in an outpatient parenteral antibiotic therapy service. J Clin Nurs. 2014;23(9\u0026ndash;10):1318\u0026ndash;22. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1111/jocn.12376\u003c/span\u003e\u003cspan address=\"https://doi:10.1111/jocn.12376\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFrieler S, Hanusrichter Y, Bellova P, Ge\u0026szlig;mann J, Schildhauer TA, Baecker H. Facing multidrug-resistant pathogens in periprosthetic joint infections with self-administered outpatient parenteral antimicrobial therapy-A prospective cohort study. J Orthop Res. 2021;39(2):320\u0026ndash;32. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1002/jor.24906\u003c/span\u003e\u003cspan address=\"https://doi:10.1002/jor.24906\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGanguly A, de la Flor C, Alvarez K, Brown LS, Mang NS, Smartt J, et al. Safety and Efficacy of Ceftriaxone in the Treatment of Methicillin-Susceptible \u003cem\u003eStaphylococcus aureus\u003c/em\u003e Bloodstream Infections: A Noninferiority Retrospective Cohort Study. Ann Pharmacother. 2023;57(4):425\u0026ndash;31. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1177/10600280221115460\u003c/span\u003e\u003cspan address=\"https://doi:10.1177/10600280221115460\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGardiol C, Voumard R, Cochet C, de Valli\u0026egrave;re S. Setting up an outpatient parenteral antimicrobial therapy (OPAT) unit in Switzerland: review of the first 18 months of activity. Eur J Clin Microbiol Infect Dis. 2016;35(5):839\u0026ndash;45. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s10096-016-2606-z\u003c/span\u003e\u003cspan address=\"10.1007/s10096-016-2606-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://\u003c/span\u003e\u003cspan address=\"https://\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHatcher J, Costelloe C, Cele R, Viljanen A, Samarasinghe D, Satta G, et al. Factors associated with successful completion of outpatient parenteral antibiotic therapy (OPAT): A 10-year review from a large West London service. Int J Antimicrob Agents. 2019;54(2):207\u0026ndash;14. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.ijantimicag.2019.04.008\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.ijantimicag.2019.04.008\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKarimaghaei S, Rao A, Chijioke J, Finch N, Nigo M. Characteristics, safety and cost-effectiveness analysis of self-administered outpatient parenteral antibiotic therapy via a disposable elastomeric continuous infusion pump at two county hospitals in Houston, Texas, United States. J Clin Pharm Ther. 2022;47(2):211\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1111/jcpt.13550\u003c/span\u003e\u003cspan address=\"https://doi:10.1111/jcpt.13550\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKeller SC, Dzintars K, Gorski LA, Williams D, Cosgrove SE. Antimicrobial Agents and Catheter Complications in Outpatient Parenteral Antimicrobial Therapy. Pharmacotherapy. 2018;38(4):476\u0026ndash;81. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1002/phar.2099\u003c/span\u003e\u003cspan address=\"https://doi:10.1002/phar.2099\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKeller SC, Cosgrove SE, Kohut M, Krosche A, Chang HE, Williams D, et al. Hazards from physical attributes of the home environment among patients on outpatient parenteral antimicrobial therapy. Am J Infect Control. 2019;47(4):425\u0026ndash;30. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.ajic.2018.09.020\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.ajic.2018.09.020\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKeller SC, Tamma P, Salinas A, Williams D, Cosgrove SE, Gurses AP. (a) Engaging Patients and Caregivers in a Transdisciplinary Effort to Improve Outpatient Parenteral Antimicrobial Therapy. Open Forum Infect Dis. 2020;7(6):ofaa188. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/ofid/ofaa18\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/ofid/ofaa18\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKeller SC, Cosgrove SE, Arbaje AI, Chang RH, Krosche A, Williams D, Gurses AP, editors. (b) It's Complicated: Patient and Informal Caregiver Performance of Outpatient Parenteral Antimicrobial Therapy-Related Tasks. Am J Med Qual. 2020;35(2):133\u0026ndash;146. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1177/1062860619853345\u003c/span\u003e\u003cspan address=\"https://doi:10.1177/1062860619853345\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKeller SC, Salinas A, Gurses AP, Levering M, Hohl D, Hirsch D, et al. Implementing a Toolkit to Improve the Education of Patients on Home-Based Outpatient Parenteral Antimicrobial Therapy (OPAT). Jt Comm J Qual Patient Saf. 2022;48(9):468\u0026ndash;74. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.jcjq.2022.05.008\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.jcjq.2022.05.008\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKieran J, O'Reilly A, Parker J, Clarke S, Bergin C. Self-administered outpatient parenteral antimicrobial therapy: a report of three years' experience in the Irish healthcare setting. Eur J Clin Microbiol Infect Dis. 2009;28(11):1369\u0026ndash;74. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1007/s10096-009-0794-5\u003c/span\u003e\u003cspan address=\"https://doi:10.1007/s10096-009-0794-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKilinc F, Setzer M, Behmanesh B, Jussen D, Gessler F, Keil F (a) Safety and feasibility of outpatient parenteral antimicrobial therapy for patients with spinal infection, et al. editors. Sci Rep. 2023;13(1):6863. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1038/s41598-023-33502-7\u003c/span\u003e\u003cspan address=\"https://doi:10.1038/s41598-023-33502-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKilinc F, Setzer M, Behmanesh B, Jussen D, Gessler F, Bayerl S (b) Effectiveness of outpatient parenteral antimicrobial therapy (OPAT) for patients with cranial infection, et al. editors. Front Med (Lausanne). 2023;10:1202969. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.3389/fmed.2023.1202969\u003c/span\u003e\u003cspan address=\"https://doi:10.3389/fmed.2023.1202969\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKrah NM, Bardsley T, Nelson R, Esquibel L, Crosby M, Byington CL, et al. Economic Burden of Home Antimicrobial Therapy: OPAT Versus Oral Therapy. Hosp Pediatr. 2019;9(4):234\u0026ndash;40. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1542/hpeds.2018-0193\u003c/span\u003e\u003cspan address=\"https://doi:10.1542/hpeds.2018-0193\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee B, Tam I, Weigel B 4th, Breeze JL, Paulus JK, Nelson J, et al. Comparative outcomes of β-lactam antibiotics in outpatient parenteral antibiotic therapy: treatment success, readmissions and antibiotic switches. J Antimicrob Chemother. 2015;70(8):2389\u0026ndash;96. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/jac/dkv130\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/jac/dkv130\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eL\u0026oacute;pez-Cort\u0026eacute;s LE, Ayerbe-Garc\u0026iacute;a R, Carrasco-Hern\u0026aacute;ndez L, Fraile-Ramos E, Carmona-Caballero JM, Quintana-Gallego E, Valido-Morales A, et al. DOMUS OPAT Group. Outpatient Parenteral Antimicrobial Treatment for Non-Cystic Fibrosis Bronchiectasis Exacerbations: A Prospective Multicentre Observational Cohort Study. Respiration. 2019;98(4):294\u0026ndash;300. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1159/000501085\u003c/span\u003e\u003cspan address=\"https://doi:10.1159/000501085\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohammadi S, MacKay K, Ward TT, Forrest GN. Clinical outcomes of a veterans affairs outpatient antimicrobial treatment program. South Med J. 2013;106(6):345\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1097/SMJ.0b013e3182967e8f\u003c/span\u003e\u003cspan address=\"https://doi:10.1097/SMJ.0b013e3182967e8f\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMont\u0026oacute;n C, Pomares X, Mujal A. Home intravenous antimicrobial therapy in chronic respiratory disease. Arch Bronconeumol. 2013;49(4):174\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.arbres.2012.09.008\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.arbres.2012.09.008\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. English, Spanish.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMujal A, Sola J, Hernandez M, Villarino MA, Baylina M, Tajan J, et al. Safety and effectiveness of outpatient parenteral antimicrobial therapy in older people. J Antimicrob Chemother. 2016;71(5):1402\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/jac/dkv478\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/jac/dkv478\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePajar\u0026oacute;n M, Lisa M, Fern\u0026aacute;ndez-Miera MF, Due\u0026ntilde;as JC, Allende I, Arnaiz AM, et al. Efficiency of a self-administered outpatient parenteral antimicrobial therapy (s-opat) for infective endocarditis within the context of a shortened hospital admission based on hospital at home program. Hosp Pract. 2017;45(5):246\u0026ndash;52. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1080/21548331.2017.1398588\u003c/span\u003e\u003cspan address=\"https://doi:10.1080/21548331.2017.1398588\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePonce Gonz\u0026aacute;lez MA, Mir\u0026oacute;n Rubio M, Mujal Martinez A, Estrada Cuxart O, Fiuza Perez D, Salas Reinoso L, et al. Effectiveness and safety of outpatient parenteral antimicrobial therapy in acute exacerbation of chronic obstructive pulmonary disease. Int J Clin Pract. 2017;71(12). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1111/ijcp.13022\u003c/span\u003e\u003cspan address=\"https://doi:10.1111/ijcp.13022\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaillen L, Arensdorff L, Moulin E, Voumard R, Cochet C, Boillat-Blanco N, et al. Patient satisfaction in an outpatient parenteral antimicrobial therapy (OPAT) unit practising predominantly self-administration of antibiotics with elastomeric pumps. Eur J Clin Microbiol Infect Dis. 2017;36(8):1387\u0026ndash;92. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1007/s10096-017-2944-5\u003c/span\u003e\u003cspan address=\"https://doi:10.1007/s10096-017-2944-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSanroma P, Mu\u0026ntilde;oz P, Mir\u0026oacute;n-Rubio M, Aguilera A, Estrada O, Garc\u0026iacute;a D, et al. Effectiveness and safety of ertapenem used in hospital-at-home units: data from Spanish Outpatient Parenteral Antimicrobial Therapy Registry. Future Microbiol. 2018;13:1363\u0026ndash;73. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.2217/fmb-2018-0065\u003c/span\u003e\u003cspan address=\"https://doi:10.2217/fmb-2018-0065\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchmidt-Hellerau K, Baade N, G\u0026uuml;nther M, Scholten N, Lindemann CH, Leisse C, et al. Outpatient parenteral antimicrobial therapy (OPAT) in Germany: insights and clinical outcomes from the K-APAT cohort study. Infection. 2024;52(4):1407\u0026ndash;14. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1007/s15010-024-02199-9\u003c/span\u003e\u003cspan address=\"https://doi:10.1007/s15010-024-02199-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSeetoh T, Lye DC, Cook AR, Archuleta S, Chan M, Sulaiman Z, et al. An outcomes analysis of outpatient parenteral antibiotic therapy (OPAT) in a large Asian cohort. Int J Antimicrob Agents. 2013;41(6):569\u0026ndash;73. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.ijantimicag.2013.01.015\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.ijantimicag.2013.01.015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSriskandarajah S, Ritchie B, Sluggett JK, Reynolds JGHAKJ. Safety of Nurse- and Self-Administered Paediatric Outpatient Parenteral Antimicrobial Therapy. Antibiot (Basel). 2020;9(11):761. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.3390/antibiotics9110761\u003c/span\u003e\u003cspan address=\"https://doi:10.3390/antibiotics9110761\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSubedi S, Looke DF, McDougall DA, Sehu MM, Playford EG. Supervised self-administration of outpatient parenteral antibiotic therapy: a report from a large tertiary hospital in Australia. Int J Infect Dis. 2015;30:161\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ijid.2014.11.021\u003c/span\u003e\u003cspan address=\"10.1016/j.ijid.2014.11.021\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTwiddy M, Czoski Murray CJ, Mason SJ, Meads D, Wright JM, Mitchell ED, et al. CIVAS study team. A qualitative study of patients' feedback about Outpatient Parenteral Antimicrobial Therapy (OPAT) services in Northern England: implications for service improvement. BMJ Open. 2018;8(1):e019099. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1136/bmjopen-2017-019099\u003c/span\u003e\u003cspan address=\"https://doi:10.1136/bmjopen-2017-019099\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUnderwood J, Marks M, Collins S, Logan S, Pollara G. Intravenous catheter-related adverse events exceed drug-related adverse events in outpatient parenteral antimicrobial therapy. J Antimicrob Chemother. 2019;74(3):787\u0026ndash;90. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/jac/dky474\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/jac/dky474\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYagnik KJ, Brown LS, Saad HA, Alvarez K, Mang N, Bird CE, et al. Implementation of IV Push Antibiotics for Outpatients During a National Fluid Shortage Following Hurricane Maria. Open Forum Infect Dis. 2022;9(5):ofac117. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/ofid/ofac117\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/ofid/ofac117\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZikri A, Al-Faraj H, Kamas N, Al Zahrani J, Bu Khamseen H, Alshahoub W, et al. Implementing the First Outpatient Parenteral Antimicrobial Therapy (OPAT) Program to Utilize Disposable Elastomeric Pumps in the Gulf Region: Results From a Tertiary Teaching Hospital in the Kingdom of Saudi Arabia. Cureus. 2021;13(12):e20179. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.7759/cureus.20179\u003c/span\u003e\u003cspan address=\"https://doi:10.7759/cureus.20179\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEskes AM, Tobiano G, Carlini J, Kuijpers C, Musters SCW, Chaboyer W. Fundamentally shifting discharge planning and post-hospital care. Int J Nurs Stud. 2023;145:104533. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.ijnurstu.2023.104533\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.ijnurstu.2023.104533\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLevoy K, Rivera E, McHugh M, Hanlon A, Hirschman KB, Naylor MD. Caregiver Engagement Enhances Outcomes Among Randomized Control Trials of Transitional Care Interventions: A Systematic Review and Meta-analysis. Med Care. 2022;60(7):519\u0026ndash;29. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1097/MLR.0000000000001728\u003c/span\u003e\u003cspan address=\"https://doi:10.1097/MLR.0000000000001728\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChapman ALN, Patel S, Horner C, Green H, Guleri A, Hedderwick S, et al. Updated good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults and children in the UK. JAC Antimicrob Resist. 2019;1(2):dlz026. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/jacamr/dlz026\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/jacamr/dlz026\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCarter B, Carrol ED, Porter D, Peak M, Taylor-Robinson D, Fisher-Smith D, et al. Delivery, setting and outcomes of paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT): a scoping review. BMJ Open. 2018;8(11):e021603. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1136/bmjopen-2018-021603\u003c/span\u003e\u003cspan address=\"https://doi:10.1136/bmjopen-2018-021603\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMahoney MV, Childs-Kean LM, Khan P, Rivera CG, Stevens RW, Ryan KL. Recent Updates in Antimicrobial Stewardship in Outpatient Parenteral Antimicrobial Therapy. Curr Infect Dis Rep. 2021;23(12):24. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1007/s11908-021-00766-x\u003c/span\u003e\u003cspan address=\"https://doi:10.1007/s11908-021-00766-x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaldanha IJ, Dodd S, Gorst SL, Williamson PR. More than half of systematic reviews have relevant core outcome sets. J Clin Epidemiol. 2021;136:168\u0026ndash;79. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.jclinepi.2021.04.019\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.jclinepi.2021.04.019\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohammed SA, Cotta MO, Assefa GM, Erku D, Sime F. Barriers and facilitators for the implementation and expansion of outpatient parenteral antimicrobial therapy: a systematic review. J Hosp Infect. 2024;147:1\u0026ndash;16. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.jhin.2024.02.006\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.jhin.2024.02.006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBerrevoets MAH, Ten Oever J, Oerlemans AJM, Kullberg BJ, Hulscher ME, Schouten JA. Quality Indicators for Appropriate Outpatient Parenteral Antimicrobial Therapy in Adults: A Systematic Review and RAND-modified Delphi Procedure. Clin Infect Dis. 2020;70(6):1075\u0026ndash;82. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/cid/ciz362\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/cid/ciz362\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWolly ZT, Roberts JA, Gilchrist M, McCarthy K, Sime FB. Current practices and challenges of outpatient parenteral antimicrobial therapy: a narrative review. J Antimicrob Chemother. 2024;79(9):2083\u0026ndash;102. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/jac/dkae177\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/jac/dkae177\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDoyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;3(1):e001570. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1136/bmjopen-2012-001570\u003c/span\u003e\u003cspan address=\"https://doi:10.1136/bmjopen-2012-001570\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eManary MP, Boulding W, Staelin R, Glickman SW. The patient experience and health outcomes. N Engl J Med. 2013;368(3):201\u0026ndash;3. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1056/NEJMp1211775\u003c/span\u003e\u003cspan address=\"https://doi:10.1056/NEJMp1211775\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBellamy R. Outpatient parenteral antimicrobial therapy. Br J Hosp Med (Lond). 2018;79(1):12\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.12968/hmed.2018.79.1.12\u003c/span\u003e\u003cspan address=\"10.12968/hmed.2018.79.1.12\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://\u003c/span\u003e\u003cspan address=\"https://\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHerdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20(10):1727\u0026ndash;36. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1007/s11136-011-9903-x\u003c/span\u003e\u003cspan address=\"https://doi:10.1007/s11136-011-9903-x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrouwer WB, van Exel NJ, van Gorp B, Redekop WK. The CarerQol instrument: a new instrument to measure care-related quality of life of informal caregivers for use in economic evaluations. Qual Life Res. 2006;15(6):1005\u0026ndash;21. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1007/s11136-005-5994-6\u003c/span\u003e\u003cspan address=\"https://doi:10.1007/s11136-005-5994-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBenson T, Potts HWW, Bark P, Bowman C. Development and initial testing of a Health Confidence Score (HCS). BMJ Open Qual. 2019;8(2):e000411. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1136/bmjoq-2018-000411\u003c/span\u003e\u003cspan address=\"https://doi:10.1136/bmjoq-2018-000411\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Janabi H, Frew E, Brouwer W, Rappange D, Van Exel J. The inclusion of positive aspects of caring in the Caregiver Strain Index: tests of feasibility and validity. Int J Nurs Stud. 2010;47(8):984\u0026ndash;93. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1016/j.ijnurstu.2009.12.015\u003c/span\u003e\u003cspan address=\"https://doi:10.1016/j.ijnurstu.2009.12.015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBonsel JM, Itiola AJ, Huberts AS, Bonsel GJ, Penton H. The use of patient-reported outcome measures to improve patient-related outcomes - a systematic review. Health Qual Life Outcomes. 2024;22(1):101. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1186/s12955-024-02312-4\u003c/span\u003e\u003cspan address=\"https://doi:10.1186/s12955-024-02312-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChallener DW, Fida M, Martin P, Rivera CG, Virk A, Walker LW. Machine learning for adverse event prediction in outpatient parenteral antimicrobial therapy: a scoping review. J Antimicrob Chemother. 2024;79(12):3055\u0026ndash;62. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1093/jac/dkae340\u003c/span\u003e\u003cspan address=\"https://doi:10.1093/jac/dkae340\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKouwenberg LHJA, Cohen ES, Hehenkamp WJK, Snijder LE, Kampman JM, K\u0026uuml;\u0026ccedil;\u0026uuml;kkeles B, et al. The Carbon Footprint of Hospital Services and Care Pathways: A State-of-the-Science Review. Environ Health Perspect. 2024;132(12):126002. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi:10.1289/EHP14754\u003c/span\u003e\u003cspan address=\"https://doi:10.1289/EHP14754\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"infection","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infe","sideBox":"Learn more about [Infection](http://link.springer.com/journal/15010)","snPcode":"15010","submissionUrl":"https://submission.nature.com/new-submission/15010/3","title":"Infection","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"S-OPAT, self-administration, safety, clinical outcome, patient-reported outcome, scoping review","lastPublishedDoi":"10.21203/rs.3.rs-6390941/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6390941/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eThis study aimed to provide a comprehensive overview of the existing literature on Self-administered Outpatient Parenteral Antimicrobial Therapy (S-OPAT), focusing on safety and clinical outcomes, factors influencing these outcomes, and the experiences of patients and caregivers.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe searched the databases MEDLINE, CINAHL, Embase and Cochrane library. Publications were included if they reported on the clinical outcomes, safety, and/or experiences of patients and caregivers with S-OPAT. Study selection and data extraction were performed independently by two reviewers. Quantitative and qualitative data were summarized in data charting forms.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003e Forty-four studies were included: 41 primary studies, 2 systematic reviews and 1 clinical guideline. Clinical outcomes were reported in 17 and safety in 23 primary studies. Eleven studies compared S-OPAT to other OPAT delivery models. These studies showed that all models were generally comparable regarding clinical outcomes, but two studies reported an increased number of adverse events with S-OPAT. Nine studies, exploring a total of 7 potential risk factors, identified older age, comorbidities and \u003cem\u003eStaphylococcus aureus\u003c/em\u003e infections as contributors to adverse events. The results of 14 studies on patient-centred outcomes showed that patients and caregivers considered S-OPAT a suitable alternative to other OPAT delivery models.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWe conclude that S-OPAT is a viable model of care, demonstrating favourable clinical outcomes, although some safety concerns have been reported. The growing care demand now and in the future urges further development of S-OPAT care. Gaps of knowledge still exist, and we provide recommendations for future research.\u003c/p\u003e","manuscriptTitle":"Clinical and patient-reported outcomes of Self-administered Outpatient Parenteral Antimicrobial Treatment (S-OPAT): a scoping review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-16 09:00:49","doi":"10.21203/rs.3.rs-6390941/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Accepted","date":"2025-04-28T14:29:43+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-28T12:57:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"224332420133817420053371167944899414540","date":"2025-04-08T11:14:14+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-08T10:07:17+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-08T04:23:02+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-08T02:54:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"Infection","date":"2025-04-07T06:39:43+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"infection","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infe","sideBox":"Learn more about [Infection](http://link.springer.com/journal/15010)","snPcode":"15010","submissionUrl":"https://submission.nature.com/new-submission/15010/3","title":"Infection","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"4953b9be-77d6-496d-b019-06557b3c3139","owner":[],"postedDate":"April 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-05-19T16:03:06+00:00","versionOfRecord":{"articleIdentity":"rs-6390941","link":"https://doi.org/10.1007/s15010-025-02549-1","journal":{"identity":"infection","isVorOnly":false,"title":"Infection"},"publishedOn":"2025-05-12 15:58:12","publishedOnDateReadable":"May 12th, 2025"},"versionCreatedAt":"2025-04-16 09:00:49","video":"","vorDoi":"10.1007/s15010-025-02549-1","vorDoiUrl":"https://doi.org/10.1007/s15010-025-02549-1","workflowStages":[]},"version":"v1","identity":"rs-6390941","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6390941","identity":"rs-6390941","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}