Antimicrobial Key Considerations

The antimicrobial choice should be based on the principles contained in the local antimicrobial stewardship programme, taking into account:

• The antimicrobial spectrum (narrow, specific to the organism & minimal potential for collateral damage).

• Antimicrobial penetration and target site (good tissue concentration at the site of infection).

• The antimicrobial’s side effect profile (minimal and well tolerated drug).

• Antimicrobial drug–drug and drug–host interactions (no interactions).

• Antimicrobial dose and dosing frequency (once daily or less frequent).

• The antimicrobial’s mode of delivery (bolus).

• Orally bioavailable antimicrobial alternatives.

• The duration of antimicrobial therapy and criteria for stopping or switching.

Of particular importance is the need for antimicrobial agents (both parenteral and oral) used within OPAT programmes to be approved via an antimicrobial stewardship committee and, as necessary, hospital new medicine committees or equivalent. Evidence for their use in terms of clinical efficacy, safety and financial data should be evaluated.

Watch the full video with the OPAT AMT Pharmacist.