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Delivery, setting and outcomes of paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT): a scoping review
  1. Bernie Carter1,
  2. Enitan D Carrol2,
  3. David Porter7,
  4. Matthew Peak3,
  5. David Taylor-Robinson4,
  6. Debra Fisher-Smith2,
  7. Lucy Blake1
  1. 1 Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
  2. 2 Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
  3. 3 Paediatric Medicines Research Unit, Alder Hey Children’s Hospital, Liverpool, UK
  4. 4 Department of Public Health and Policy, University of Liverpool, Liverpool, UK
  5. 7 Department of Infectious Diseases and Immunology, Alder Hey Children’s Hospital, Liverpool, UK
  1. Correspondence to Professor Bernie Carter; bernie.carter{at}edgehill.ac.uk

Abstract

Background There has been little detailed systematic consideration of the delivery, setting and outcomes of paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT), although individual studies report that it is a safe and effective treatment.

Objective This scoping review aimed to examine what is known about the delivery, settings and outcomes of paediatric OPAT and to identify key knowledge deficits.

Design A scoping review using Arksey and O’Malley’s framework was undertaken.

Data sources Keywords were identified and used to search MEDLINE and CINAHL.

Study appraisal methods Primary research studies were included if samples comprised children and young people 21 or under, who had received OPAT at home or in a day treatment centre. The Mixed Methods Appraisal Tool was used to review the methodological quality of the studies

Main findings From a preliminary pool of 157 articles, 51 papers were selected for full review. 19 studies fitted the inclusion criteria. Factors influencing delivery of OPAT were diverse and included child’s condition, home environment, child-related factors, parental compliance, training and monitoring. There is little consensus as to what constitutes success of and adverse events in OPAT.

Conclusions Future studies need to clearly define and use success indicators and adverse events in order to provide evidence that paediatric OPAT is safe and effective.

Implications Consensus outcomes that include child and parent perspectives need to be developed to allow a clearer appreciation of a successful paediatric OPAT service.

  • infectious diseases

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Footnotes

  • Contributors All authors (BC, EC, DP, MP, DT-R, DF-S and LB) contributed to the conception and design of the study. Article reviewing, scoring and data analysis has been performed by BC and LB with assistance from EC. All authors (BC, EC, DP, MP, DT-R, DF- S and LB) have made contributions to the drafting and revision of the article.

  • Funding LB, DP and DF-S were part funded by The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast (NIHR CLAHRC NWC) for undertaking this review. BC received no funding. DTR is funded by the MRC on a Clinician Scientist Fellowship (MR/P008577/1).

  • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The summary chart has been provided as an online supplementary table.

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