Practice guidelines for outpatient parenteral antimicrobial therapy (OPAT) in Germany

The practice guideline for outpatient parenteral antimicrobial therapy (OPAT) aims to encourage broader adoption of OPAT into routine clinical practice in Germany. The guideline was developed according to the guideline development framework by the Association of the Scientific Medical Societies (AWMF) in Germany. Literature search was conducted, and expert recommendations were formulated through consensus and published as an AWMF S1 guideline (expert group recommendations with consensus development in an informal process). OPAT is a safe and effective alternative to inpatient care for managing selected infectious diseases (ID) entities, which require intravenous antimicrobial therapy (AMT). ID specialists play a critical role in determining the indications for OPAT, the selection of suitable patients and the development of treatment plans. Specialist-led OPAT programs have been shown to enhance treatment efficacy, reduce hospital readmissions, and decrease healthcare costs. A structured, checklist-based approach is used to evaluate infection severity, available therapeutic options, patient comorbidities, and home care conditions. Adherence to antimicrobial stewardship (AMS) principles as well as regular clinical and laboratory monitoring are essential to ensure appropriate antimicrobial use and minimize adverse events, catheter-related complications and the risk of resistance. The selection of adequate vascular access is based on patient-specific factors, characteristics of the indicated antimicrobial and treatment duration, optimizing both safety and patient comfort. OPAT is a safe, cost-effective alternative to inpatient care, requiring specialists' ID expertise and AMS. The guideline provides a framework for successful implementation in Germany.