Work

Outpatient parenteral antimicrobial therapy (OPAT) guidelines: A systematic review

Year: 2026

Type: review

Abstract: BACKGROUND: To guarantee the safe and effective provision of Outpatient Parenteral Antimicrobial Therapy (OPAT), appropriate practice guidelines are essential for offering the necessary recommendations. This study aimed to synthesise and appraise published OPAT clinical practice guidelines. METHOD: Bibliographic databases were systematically searched for OPAT guidelines from inception to 14 July 2026, complemented by hand-searching. All guidelines in English were included. Reporting and methodological quality were evaluated using the Reporting Items for Practice Guidelines in Healthcare (RIGHT) and AGREE II tools. Correlations between AGREE II and RIGHT domain scores were investigated using Spearman's correlation. Inter-rater agreement was assessed using intraclass correlation coefficients estimated with a two-way random effects model. RESULTS: Seven guidelines met the eligibility criteria. Almost all guidelines were published or revised within the last 10 years, with the earliest one released in 2004 and the most recent one published in 2026. Most guidelines aimed to standardise the delivery, safety, and effectiveness of OPAT in their respective healthcare settings. The average overall score for methodological quality of the guidelines from AGREE II was 81.0%, while the average overall reporting quality score of the guidelines using the RIGHT instrument was 61.6%. There was an overall positive correlation between AGREE II and RIGHT domain scores. CONCLUSIONS: The OPAT guidelines have substantial heterogeneity in methodological quality and reporting completeness. While clear clinical recommendations were noted, lack of evidence syntheses methods and quality assurance were identified. Robust and transparent OPAT guidelines are critical to ensure safe, sustainable, and equitable expansion of outpatient antimicrobial care worldwide.

Source: Journal of Global Antimicrobial Resistance

DOI: 10.1016/j.jgar.2026.09.015

Authors: Audrey Huili Lim, Norazida Ab Rahman, Afra Nahdia Marizan Nor, Nor Arisah Misnan

Institutions: National Institutes of Health, Ministry of Health, Hospital Selayang, Hospital Sungai Buloh

Language: English

Topic: Clinical practice guidelines implementation

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,890