Cardiology>>>>>Valvular heart disease and EndocarditisQuestion 22#Which one of the following statements regarding outpatient parenteral antibiotic therapy (OPAT) for infective endocarditis is true?
A. OPAT can be considered in oral-streptococci-positive endocarditis in stable patients with no complications in the critical phase (0–2 weeks)
B. Complications are rare in the first 2 weeks
C. OPAT in patients who have received inpatient therapy for 3 weeks can be considered despite the presence of heart failure
D. Daily post-discharge evaluation physician review is necessary for OPAT
E. Neurological features are not a contraindication to OPAT
Correct Answer is
AComment:The following criteria determine the suitability of outpatient parenteral antibiotic therapy (OPAT) for infective endocarditis.
- Critical phase (0–2 weeks): complications occur during this phase; inpatient treatment preferable during this phase; consider OPAT if oral streptococci, patient is stable, and no complications
- Continuation phase (beyond week 2): consider OPAT if medically stable. Do not consider OPAT if heart failure is present or there are concerning echocardiographic features, neurological signs, or renal impairment. Regular post-discharge evaluation is possible (nurse, once daily; physician in charge, once or twice weekly).