Multicentre insights into OPAT: a comprehensive analysis of Türkiye’s unstructured system

Abstract Background/Objective: Outpatient parenteral antimicrobial therapy (OPAT) is a well-established, cost-effective treatment modality delivered through structured, multidisciplinary programs worldwide. In Türkiye, no standardized OPAT framework exists; patients continue therapy through emergency departments, primary care facilities, or privately funded nursing services. This is the first multicentre study to evaluate clinical outcomes, treatment adherence, and patient satisfaction with OPAT in Türkiye. Methods This prospective multicentre study enrolled adult patients receiving OPAT for chronic osteomyelitis, spondylodiscitis, prosthetic joint infection, or urinary tract infection across 20 hospitals in Türkiye between March and September 2024. Results A total of 265 patients were included (53.2% male; mean age 61.4 ± 13.5 years). Gram-positive pathogens predominated (76%); the most frequently used antibiotics were teicoplanin (70.5%), ceftriaxone (16.6%), and aminoglycosides (6.8%). The clinical success rate was 94.3%. ADEs led to treatment discontinuation in only 3 patients (1.1%). OPAT initiated at university hospitals was significantly more likely to be continued via emergency departments than at state hospitals (p = 0.010). Treatment-related adverse events occurred significantly more frequently outside dedicated OPAT units (18% vs. 3.1%; p = 0.03). Patient satisfaction was high overall; however, urinary tract infection patients reported significantly greater satisfaction than those with bone and joint infections across multiple domains. Conclusion The absence of a structured OPAT system in Türkiye increases emergency department burden and elevates complication risk. Despite this, high clinical success rates and patient satisfaction confirm OPAT's potential as a viable alternative to inpatient care. A standardized, multidisciplinary OPAT framework is imperative to improve patient safety and optimize healthcare resource utilization.

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Journal
BMC Infectious Diseases
Published
2026-08-25
DOI
https://doi.org/10.1186/s12879-026-14269-4
Primary Topic
Antibiotics Pharmacokinetics and Efficacy
Type
article
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article

Multicentre insights into OPAT: a comprehensive analysis of Türkiye’s unstructured system

Ayşe Şenbaba Kara, Halime Araz, Cihan Semet, Ahmet Doǧan et al.
BMC Infectious Diseases
Antibiotics Pharmacokinetics and Efficacy
article

Multicentre insights into OPAT: a comprehensive analysis of Türkiye’s unstructured system

Ayşe Şenbaba Kara, Halime Araz, Cihan Semet, Ahmet Doǧan, Yasemin Çakır Kıymaz, Mehmet Çelik, Arzu Tarakçı, Barış Manavlı, Belgin Coşkun, Neşe Saltoğlu, Özge Eren Korkmaz, Lütfiye Nilsun Altunal, Yakup Gezer, Uğur Önal, Hacer Demirköse, Melike Nur Özçelik, Gözde Dalgan, Büşra Tanır, Meryem Sena Toker, Elif Agüloğlu Bali, Eda Alp, Cigdem Mermutluoglu, Süleyman Koç, Sibel Karabulut, Sevda Özdemir Al, Duygu Çerçioğlu-Özdemir, Feyza Nur Akçin Balan, Elif Yılmaz İlmin, Petek Konya
article en

Abstract

Abstract Background/Objective: Outpatient parenteral antimicrobial therapy (OPAT) is a well-established, cost-effective treatment modality delivered through structured, multidisciplinary programs worldwide. In Türkiye, no standardized OPAT framework exists; patients continue therapy through emergency departments, primary care facilities, or privately funded nursing services. This is the first multicentre study to evaluate clinical outcomes, treatment adherence, and patient satisfaction with OPAT in Türkiye. Methods This prospective multicentre study enrolled adult patients receiving OPAT for chronic osteomyelitis, spondylodiscitis, prosthetic joint infection, or urinary tract infection across 20 hospitals in Türkiye between March and September 2024. Results A total of 265 patients were included (53.2% male; mean age 61.4 ± 13.5 years). Gram-positive pathogens predominated (76%); the most frequently used antibiotics were teicoplanin (70.5%), ceftriaxone (16.6%), and aminoglycosides (6.8%). The clinical success rate was 94.3%. ADEs led to treatment discontinuation in only 3 patients (1.1%). OPAT initiated at university hospitals was significantly more likely to be continued via emergency departments than at state hospitals (p = 0.010). Treatment-related adverse events occurred significantly more frequently outside dedicated OPAT units (18% vs. 3.1%; p = 0.03). Patient satisfaction was high overall; however, urinary tract infection patients reported significantly greater satisfaction than those with bone and joint infections across multiple domains. Conclusion The absence of a structured OPAT system in Türkiye increases emergency department burden and elevates complication risk. Despite this, high clinical success rates and patient satisfaction confirm OPAT's potential as a viable alternative to inpatient care. A standardized, multidisciplinary OPAT framework is imperative to improve patient safety and optimize healthcare resource utilization.

BMC Infectious Diseases
Dicle University (TR), Tekirdağ Namık Kemal University (TR), Sivas Cumhuriyet Üniversitesi (TR), Ministry of Health (TR), Bursa Uludağ Üni̇versi̇tesi̇ (TR), Ankara University (TR), Dokuz Eylül University (TR), State Hospital (GB), Bandırma Onyedi Eylül University (TR), Eskişehir City Hospital (TR), Memorial Ankara Hospital (TR), Ümraniye Eğitim ve Araştırma Hastanesi (TR), Istanbul University-Cerrahpaşa (TR), Suleyman Demirel University (KZ), Botkin Hospital (RU), Konya Eğitim ve Araştırma Hastanesi (TR), Kayseri Eğitim ve Araştırma Hastanesi (TR), Başkent University Hospital (TR), Sağlık Bilimleri Üniversitesi (TR), Afyon Kocatepe University (TR), Istanbul University (TR), Bolu Abant İzzet Baysal University (TR), Harran University (TR)
Openalex Percentile: Top 31%
Antibiotics Pharmacokinetics and Efficacy
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