Five years experience of Paediatric Outpatient Parenteral Antimicrobial Therapy in a portuguese secondary hospital

Introdution: Paediatric Outpatient Parenteral Antimicrobial Therapy (OPAT) involves parenteral antimicrobial administration for at least two consecutive days without hospitalization.This study aimed to characterize OPAT practices in a portuguese level II hospital. Materials and Methods:A descriptive, retrospective, single-center study was conducted, including patients under 18 years who underwent OPAT between January 2020, and June 2024.Data were extracted from electronic clinical records, covering demographic data, referral reasons, hospitalization and treatment duration, antimicrobials used, microbiological results, adverse effects, and clinical outcomes.Admission days saved were analyzed.Results and Discussion: A total of 188 patients underwent 201 OPAT episodes, with 686 ceftriaxone administrations.The average patient age was 4 years (±4.3 years); 54% were male.Most episodes (87%) followed hospitalization, 13% originated on the emergency department.OPAT lasted an average of 3.4 days (range: 1-15; median: 3), saving a total of 152.4 bed days per year.Common indications included suspected occult bacteremia (32%), fever in patients with sickle cell disease (15%), acute otitis media (14%), pneumonia (11%), suspected bacterial gastroenteritis (8%), acute tonsillitis (5%), and typhoid fever (2%).Isolated pathogens included Campylobacter jejuni (23%) and Salmonella enteritidis (12%) from stool cultures, and Salmonella typhi (15%) from blood cultures.Adverse events were reported in 40 episodes (20%), with the majority being complications related to the vascular device.The clinical outcomes were favorable in all episodes, with no readmissions.Conclusions: OPAT is a cost-effective and efficient approach for managing pediatric infections, facilitating early discharge or avoiding hospitalization for stable patients with predictable disease courses.