Evaluation of the educational quality and reliability of YouTube videos on outpatient parenteral antimicrobial therapy

OPAT allows clinically stable patients to receive prolonged intravenous antimicrobial therapy outside the hospital, improving efficiency and reducing costs while maintaining outcomes. As patients increasingly turn to YouTube for health information, concerns arise regarding the accuracy of its unregulated content, especially for therapies requiring proper self-management like OPAT. This study aimed to evaluate the educational quality, informational reliability, transparency and thematic coverage of YouTube videos related to outpatient parenteral antimicrobial therapy (OPAT), and to examine whether user engagement or source category act as reliable proxies for video quality. In this cross-sectional study, a total of 200 videos were initially identified on March 15, 2026, using OPAT-related search terms. After applying exclusion criteria (e.g., duplicates, non-English language, duration under 60 s), 107 videos were included for full assessment. Content quality was evaluated using the Global Quality Scale (GQS), informational reliability with the modified DISCERN (mDISCERN) tool and transparency with the four JAMA benchmark criteria. Video source, engagement metrics (views, likes, comments), and thematic content were also analyzed. The vast majority of the analyzed videos (90.7%; n = 97) were classified as low quality according to the GQS, while only two videos (1.9%) achieved a high-quality rating. The median mDISCERN score was 0, indicating poor overall reliability. Institutional provenance did not confer quality: 28 of 29 university-affiliated videos and 20 of 22 videos from healthcare institutions or professional associations were rated low quality, and the only two high-quality videos originated from commercial home-infusion providers. Transparency was also limited: authorship was identifiable in 66.4% of videos, but the sources of the clinical information were attributed in only 15.0%, and no video in the commercial category carried a disclosure statement. JAMA scores correlated positively with GQS and mDISCERN scores but inversely with daily user engagement, which did not differ significantly across quality categories. Crucially, the topics most relevant to patient safety—antibiotic side effects (5.6%) and catheter-related complications (3.7%)—were the least represented themes. YouTube currently offers a predominantly sparse, low-quality, and poorly attributed body of educational content regarding OPAT. Neither academic nor institutional provenance predicted quality, and critical safety topics are significantly underrepresented. There is a clear need for academic medical centers, professional societies and OPAT services to actively develop high-quality, safety-focused and transparently sourced informational content to address this gap, and for the commercial providers currently producing the most complete material to disclose their commercial interests.