Updated UK OPAT good practice recommendations add hard-to-reach groups and equitable provision

The UK good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) have been updated through a systematic literature review, expert consensus and consultation Guidance (Noble et al., PMID 42910527). The journal article outlines the key changes. Five recommendations are new: self-administration; OPAT in hard-to-reach groups; patient education; monitoring protocols for patients on complex oral antimicrobials and on new parenteral routes and regimens; and equitable provision of care. Two are amended, on thromboprophylaxis and on early collaboration with vascular access teams. The authors report that the literature shows increasing confidence among OPAT services in managing complex and comorbid patients, and evidence of innovation and collaboration, and say OPAT has the potential to improve clinical care and antimicrobial stewardship in patients with complex infections.

Only the abstract was read, not the full recommendations. What the hard-to-reach and equitable-provision recommendations require of services in practice therefore cannot be stated here, and nor can whether the self-administration recommendation addresses who is selected for self-administration. The October monthly review reported an early signal that failures of self-administered OPAT cluster in a UK cohort, so that question matters.

These are the national good practice reference for UK services, and equity of access is now named in them. For services in areas of high deprivation and in rural or dispersed settings, that gives a stated standard to audit against. Where practice stands against it cannot be told: no UK data on OPAT uptake by deprivation or rurality were found, and the source carries no international comparator for OPAT access. Services should expect to build their own data on who is and is not reached.