LAUSR

BACKGROUND Delivery of parenteral antimicrobials in non-inpatient settings (DPANS) may be through a dedicated outpatient parenteral antimicrobial therapy (OPAT) service, coordinated by hospital- or community-based specialized teams, or via an infusion service involving community-based health professionals (nurses, general practitioners) without centralized hospital oversight, or through ad hoc arrangements. DPANS varies among countries. OBJECTIVES To describe how DPANS is organized at a national level in European countries. METHODS A survey (65-item self-administered questionnaire) was conducted from February to June 2019 among infection specialists in 34 European countries on behalf of the ESCMID (European Society of Clinical Microbiology and Infectious Diseases) Study Group for Antimicrobial Stewardship (ESGAP) and the British Society for Antimicrobial Chemotherapy (BSAC). RESULTS Most countries (28/34, 82.4%) participated in the survey. DPANS was available in almost all (n=27/28, 96.4%) responding countries. DPANS was predominantly either provided via specialized OPAT services (n=17/28, 60.7%) or via infusion services (n=16/28, 57.1%), with 11 countries providing both services (39.3%). Formal OPAT team structure with specifically trained staff was reported in only 6 countries (6/17, 35.3%). Some countries (n=4, 14.3%) had no structured services but practiced DPANS via ad hoc arrangements. Costs of all stages of the process were covered for patients managed by specialized OPAT/infusion services, either completely, partially, or for specific patient groups in the majority (20/28, 71.4%) of countries. The main barriers to implement OPAT/infusion services were lack of organizational structure or guidelines. CONCLUSIONS DPANS with respect to availability and organisation is highly heterogeneous in Europe. National/European guidelines may help improve and standardize DPANS.