Safety, Efficacy and Direct/Indirect Cost Analysis of an Outpatient Antimicrobial Therapy Unit: A Prospective Cohort Study from Turkey

Introduction: Outpatient parenteral antimicrobial therapy (OPAT) is uncommon in Turkey and other developing countries, and its popularity has not increased at a satisfactory rate. We aimed to evaluate the direct and indirect cost analysis of an OPAT unit from the perspective of the Turkish health system using real-life data. Additionally, we aimed to investigate the clinical efficacy and safety of the OPAT unit and compare these parameters before and during the pandemic.Materials and Methods: Patients admitted to the OPAT unit between January 2019 and February 2021 were included in the study. The patients' medical records were obtained from the hospital's electronic database. Real-life data were used for the direct and indirect cost analyses of the OPAT unit. This data were obtained via in-person interviews.Results: In total, 307 patients were included in the study. The use of the OPAT unit saved 3040 bed days over 25 months. The end-of-treatment success rate was 92.2%. The presence of a urinary system infection, at least one comorbidity, and immunosuppressant administration were significantly higher in patients who were readmitted within 28 days for the same reason for which they were first admitted. The cost of OPAT was approximately 50% less than that incurred during hospitalization.Conclusion: Outpatient parenteral antimicrobial therapy units are effective, safe, and cost-effective in the context of the Turkish national health system.