A Pilot Longitudinal Study to Evaluate the Efficacy, Safety, and Feasibility of Outpatient Parenteral Antimicrobial Therapy, and to Identify Real-World Barriers and Facilitators in a Resource-Limited Setting.

Background: Outpatient Parenteral Antimicrobial Therapy (OPAT) offers a viable alternative to traditional hospitalization for intravenous antimicrobial treatment, especially in resource-limited settings. This pilot longitudinal study evaluates the efficacy, safety, and feasibility of OPAT, while identifying real-world barriers and facilitators in a resource-constrained environment. Methods: Conducted at AIIMS Rishikesh, this prospective observational study involved 20 patients who were systematically screened for OPAT eligibility using a predefined checklist. Patients were included if they met the criteria and demonstrated willingness for structured follow-up. Efficacy, safety, and feasibility were assessed through telephonic monitoring, patient feedback, and medical record review. Results: The cohort had a mean age of 37 years, comprising 12 males and 8 females. OPAT was administered at home, with 19 patients achieving afebrile status and clinical improvement. One patient was readmitted due to complications. Ceftriaxone was the most prescribed antimicrobial, with an average treatment duration of 14 days. OPAT reduced hospitalization by an average of 2 weeks, leading to decreased healthcare costs and enhanced patient satisfaction. Discussion: The study confirms OPAT's efficacy in managing diverse infections and its role in reducing hospital stay and costs. The favorable safety profile and positive patient feedback support OPAT as a patient-centered care option. Identified barriers and facilitators provide insights for optimizing OPAT in resource-limited settings. Conclusion: OPAT demonstrates 100% efficacy in ensuring patient safety and optimizing resource use. Further research and broader implementation are recommended, alongside dedicated training and adequate funding to address challenges and enhance outcomes. Keywords: Outpatient Parenteral Antimicrobial Therapy, OPAT, infection management, resource-limited settings, patient safety, healthcare resource optimization.