Antimicrobial stewardship in the outpatient parenteral antimicrobial therapy (OPAT) setting: the impact of prescription assessment by an infectious diseases specialist

Outpatient parenteral antimicrobial therapy in Brazil

“…Although OPAT was adopted late in Brazil, with the first large-scale experience initiated in 2013 and reported in 2016, published reports show that the country’s experiences with this type of treatment are favorable. 9–14 Publication of national guidelines, which considered the particularities of the country, allowed the dissemination of OPAT services and the advancement of dehospitalization in Brazil. 4 It is still necessary, however, to make progress with these strategies, especially regarding financing of antimicrobials.…”

“…These two publications also report on the positive impact of antimicrobial stewardship programs in the context of OPAT. 11,12 Table 5 provides a summary of studies on OPAT in Brazil.…”

“…In the private system, however, there is a predominance of home care as model of choice for OPAT. [9][10][11][12]…”

Antimicrobial Stewardship Programs in Latin America and the Caribbean: A Story of Perseverance, Challenges, and Goals

“…There was a reduction in the use of ceftriaxone, cefepime, daptomycin, and ertapenem. Importantly, an overall downwards trend of 26.6% in the use of parenteral management was evidenced [ 33 ].…”

“…Dolotario et al in Brazil and Romo-Castillo et al in Ecuador discussed the concept of ‘squeezing the balloon’ as a feature of restrictive measures, increasing antimicrobial consumption and resistance in some antibiotics as a collateral effect of the interventions in LAC [ 26 , 29 , 31 ]. In terms of prospective audits and feedback, the Brazilian study that implemented this strategy [ 33 ] shows a valuable perspective of AMS outside of high-complexity hospitals. The results of the published studies presented based on prospective audits and feedback demonstrated a positive impact.…”