Outpatient parenteral antibiotic therapy: Evaluation of practices and limits of use in rural areas in France

Abstract

Objectives: To evaluate outpatient parenteral antibiotic therapy (OPAT) practices in a French rural area.

Material and methods: Descriptive study assessing knowledge, practices, and limitations of OPAT use among hospital practitioners (HP), family physicians (FP), and private nurses (PN).

Results: OPAT (mainly ceftriaxone and penicillins) was used by 69.6%, 73.3%, and 97.7% of the 23 HPs, 45 FPs, and 46 PNs mostly for respiratory or urinary tract infections, bacteremia, and/or multidrug-resistant bacterial infections. Overall, 65.2% of HPs and 37.8% of FPs were in contact with an infectious disease specialist. Knowledge of OPAT benefits and risks was lower for FPs than HPs. The main obstacles were the patient's geographic isolation (HPs), the availability of a venous catheter, the lack of training (FPs), and the expected OPAT-associated overwork (PNs).

Conclusion: OPAT practice is weak in rural areas. Declared obstacles constitute fields of improvement for its essential expansion.

Keywords: Antibiothérapie parentérale ambulatoire; Antibiotic stewardship; Bon usage; Milieu rural; Outpatient parenteral antibiotic therapy; Rural area.