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About Parenteral Antiobiotic Therapy
Antibiotics are used to help fight bacteria within the body. They can be given orally (by mouth) or intravenously (IV) which means via a vein.
Giving them intravenously (IV) is also known as “parenteral therapy”.
To give you antibiotics intravenously, a healthcare professional inserts a small plastic tube into a vein in your arm. This tube is called an IV line (or cannula).
About Outpatient Parenteral Antibiotic Therapy (OPAT)
Usually, IV antibiotics are given in hospital on an inpatient ward. However, sometimes community nurses at your home, or nurses at an outpatient clinic, can give you antibiotics safely.
Outpatient Parenteral Antibiotic Therapy (OPAT) is when antibiotics are given to you by nurses in the community (in a clinic or your home).
Opting for OPAT is usually a joint decision between you, your doctor, a microbiologist and other members of the multi-disciplinary team (MDT) involved in your care.
While you are on OPAT you will be monitored closely, with regular reviews and blood tests. To receive your IV antibiotics, you will either attend a hospital clinic, or a community nurse will visit you at home.
Benefits of OPAT
If you are on OPAT, you can stay at home in a familiar environment, instead of staying in hospital.
Most patients feel that this gives them more independence and freedom.
If you feel well enough, you may continue with activities such as work and education.
Length of treatment
Treatment time varies from person to person. It depends on the type of infection you have. Treatment with intravenous antibiotics can take days, weeks or months.
During this time we will monitor you and keep you up to date with your progress.
The OPAT team
The OPAT team comprises:
- a microbiologist
- a medical consultant
- an antimicrobial pharmacist
- an OPAT nurse
- community nurses. These may be district nurses or specialist IV nurses.
You will also be under the care of:
- your GP
- your medical/surgical team in the hospital
- the healthcare team at the clinic where you may attend for your antibiotic treatment.
Safety advice before starting OPAT
Before you leave your hospital ward or Emergency Department (A&E), we will give you important information on safety and when to seek urgent medical attention. We will also answer any questions you may have.
Who decides if you will be offered OPAT
If you are an inpatient at Kingston Hospital who is ready to be discharged but need more antibiotic treatment, you can be considered for OPAT.
If the medical/surgical team looking after you thinks you are suitable for OPAT, they will refer you to the OPAT team.
The team will explain the OPAT process to you, so you can decide whether you want to go onto OPAT.
If you decide to go onto OPAT , the team will make arrangements to send you home safely.
If you decide against OPAT, you will not be discharged onto OPAT. We will discuss alternative options for further treatment with you, and we will arrange these.
Antibiotics on OPAT
- The hospital discharge team will be responsible for your intravenous antibiotic prescriptions, not your GP.
- If you are coming to a Kingston Hospital clinic for administration, your antibiotics will be supplied there.
- If you are having your treatment at home, the Kingston Hospital Inpatient Pharmacy will supply your full antibiotic course when you are discharged. They will also supply any materials the community nurses may need.
- In rare circumstances when your infection requires a long course of treatment, we will supply your antibiotics every 2 weeks. The OPAT team will contact you to arrange collection.
- We give people on OPAT a leaflet called ‘Information for patients at home who require intravenous therapy’. This describes the different types of IV lines that you can have. It explains how they are managed in the hospital and community.
Read the antibiotics label carefully. If your antibiotics have special storage requirements this will be stated on the label.
If there are no special storage requirements, the antibiotics can be stored at room temperature.
The nurse will usually administer your antibiotic once a day. They will administer it into your vein through the IV line. The IV line is inserted into a vein using a needle. The initial needle insertion involves a pinprick sensation, but after that the rest of the procedure is usually quite painless. The needle is removed, and the IV line is left in place and secured by a dressing.
There are many different types of IV line which can be used to give you antibiotics. The main IV lines used by Kingston Hospital are Cannula, Midline and PICC lines.
When you attend your appointment in the hospital clinic, the nurses looking after you will check that your IV line is working well. Occasionally IV lines can become blocked, or an infection can develop. Your clinic nurses will check that the skin around your IV line is not infected.
If you are being looked after in the community, the IV nurse specialist will do the same monitoring.
For more information on your IV line, refer to the Peripherally Inserted Central Catheter Line information leaflet. We will give you a copy of this leaflet when you join the OPAT service.
Please see the information about your IV line below:
| Vascular access information | To be completed |
|---|---|
| Date inserted | |
|
Vascular access information |
|
| Site of vascular access | |
| Securing device/dressing type | |
| Length inserted (cm) | |
| Length of catheter exposed (cm) |
Important
Contact your community nursing team if you are worried about your IV line (see Community nursing teams section).
In an emergency, call 999 or attend your nearest Emergency Department (A&E).
Risks and side effects of OPAT
Risks
Complications on OPAT are rare. Sometimes an allergic reaction can take place when someone is given an antibiotic. To avoid complications, we will make sure that you have the first dose of your antibiotics before you leave the hospital. This means we can monitor you for any immediate allergic reactions.
Contact the OPAT team or your community nurse if you experience an allergic reaction or any other problem.
Go to your nearest Emergency Department (A&E) if you feel you need urgent medical attention.
Side effects
Occasionally, patients develop symptoms from having a long course of antibiotics in hospital or at home. These can include:
- rash
- diarrhoea
- fever (feeling hot/cold)
- vomiting
- stomach-ache
- cramping
- loss of appetite.
If you have any of these symptoms, discuss them with the community or clinic nurses. They will inform the OPAT Team.
Follow-up appointments
The nurses will monitor you throughout your treatment at home or at the hospital clinic. They will discuss any concerns with the OPAT team. If you need follow-up appointments with the clinical team at Kingston Hospital, they will tell you before you are discharged.
During your follow-up appointment a nurse will:
- Check your blood pressure, temperature and make some other basic observations.
- Check your IV line to make sure it is working properly and there are no signs of infection.
- They may do a routine blood test to check if your blood infection markers are improving. They may administer your antibiotics.
A medical or surgical doctor will then assess you and give you any information you need for your treatment. For example this might mean continuing IV antibiotic treatment or changing to oral (by mouth) antibiotics.
Community nursing teams
Use the drop-down menu for information on how to contact your community nurses if you have any other concerns when you are at home. They will inform the OPAT hospital team or your GP.
|
East Elmbridge District Nurses |
020 8296 4440 |
| Kingston Community Rapid Response Team 8am to 6pm, Monday to Friday 9am to 5pm, weekends and bank holidays |
020 8274 7088 |
| Richmond & Hounslow Single Point of Access 7am to 7pm, Monday to Sunday |
020 8630 3943 |
| Wandsworth Community Nursing 8am to 8pm, Monday to Friday 8am to 5pm, weekends and bank holidays |
0333 300 2350 |
More information
NHS information on antibiotics
NHS information on oral (by mouth) antibiotics
EMC information about medicines licenced in the UK: ceftriaxone patient information leaflet
EMC information about medicines licenced in the UK: Ertapenem patient information leaflet
Contact information
Pharmacy Medicines Helpline, Level 4 Main Outpatient Department. Monday to Friday, 9 am to 6 pm. Weekends, 9 am to 3 pm
Kingston Hospital Lead OPAT nurse, Monday to Friday 9 am to 5 pm
Kingston Hospital Medical Day Unit, Level 7, Esher Wing (towards Canbury Ward). Monday to Friday, 9 am to 5 pm
Same Day Emergency Care (SDEC) behind Emergency Department (A&E). Monday to Sunday, 8 am to 6 pm
Telephone:
Pharmacy Medicines Helpline: 020 8934 2092
Kingston Hospital Lead OPAT nurse: 020 8934 3952 or 020 8546 7711 and ask for bleep (206)
Kingston Hospital Medical Day Unit: 020 893 43674
Same Day Emergency Care (SDEC): 020 8934 3238