• Reference Number: HEY065-2023
• Departments: Infection Prevention and Control
• Last Updated: 1 August 2023

Introduction

This leaflet has been produced to give you general information about having your intravenous antibiotic therapy as an outpatient, instead of staying in or being admitted to hospital.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and the OPAT team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

Who can receive this therapy?

The OPAT service is mostly suitable for patients with complex infections that require prolonged antibiotic treatment such as infections in bone and joints or heart valves. To receive this treatment, it will be necessary for you to travel to the OPAT clinic either daily or three times a week. Treatment times vary from 15 minutes to 2 hours depending on the type of antibiotic you require.

In order to be considered for OPAT you will be referred to a Specialist in Infectious Diseases. You will be assessed for suitability and will only have this treatment if everyone concerned with your care agrees that it is in your best interest to do so. This will include:

• You (and your family or carer)
• The consultant responsible for OPAT
• The hospital consultant in charge of your care
• The OPAT specialist nurses

The OPAT process will be explained fully to you to help you decide whether it is something you would like to consider. Once everyone is in agreement with the decision to commence OPAT, a member of the team will discuss with you a plan of care best suited to your individual needs.

If you choose not to go onto the OPAT service, or it is not suitable, then alternative options for your treatment plan will be discussed.

What are antibiotics?

Antibiotics are drugs that are used to treat infections caused by bacteria. They work by either killing bacteria or preventing them from growing.

Why do I need antibiotics?

Some infections caused by bacteria (e.g. diarrhoea) get better without antibiotics. Antibiotics do not work against viruses.  Many common infections (e.g. colds, sore throats and attacks of asthma and bronchitis) are often caused by viruses.

Antibiotics are only needed usually for prolonged or severe infections caused by bacteria when the body needs help to fight the infection.

With some infections, intravenous antibiotics are more effective than oral antibiotics at treating the severity or type of infection that has occurred. Some of our patients require both intravenous and oral antibiotics.

How quickly will the antibiotics work?

This depends on the type of infection and how unwell you are. Bacteria cause symptoms by causing inflammation in the part of the body that is infected. Even after the bacteria are killed, the inflammation can persist. This means that it may take several days for your symptoms to improve. In some chronic infections (e.g. bone infection), improvement can take much longer. Sometimes your doctor may change the type of antibiotic you are taking if they are concerned that it is not working, or if tests indicate this is necessary.

How long will I need to have the antibiotics for?

This depends on the type of infection and how unwell you are. Some infections only require a short course of antibiotics (e.g. skin infections) but other infections may need treatment for many weeks (e.g. infection in a hip replacement). You will be informed how long you will need to receive intravenous antibiotics prior to commencing your treatment. Although an initial duration may be prescribed, you should be aware that this may be changed occasionally if the OPAT consultant or OPAT specialist nurse feels you would benefit from a change in your treatment plan.

It is important that you receive the antibiotics regularly and on time to keep the right amount of antibiotic in the bloodstream. Please do not to miss any appointments.

What are the side effects of antibiotics?

Antibiotics are usually safe. The most common side effect is stomach upset. This is often mild but can include feeling sick, stomach pains and diarrhoea. Taking any antibiotic, especially for a prolonged course, can cause a fungal yeast infection commonly known as ‘thrush’. This can happen in the mouth, skin folds or around the genitalia. This is because antibiotics may destroy your body’s harmless bacteria as well as the bacteria responsible for the infection you are being treated for. It can cause some discomfort but is easy to treat. If you are suffering from any of these side effects, please discuss them with the OPAT specialist nurse.

Sometimes patients are allergic to an antibiotic. If this happens, you may start to get a rash, which may be itchy or you begin to feel wheezy. If you get these symptoms, please talk to your nurse or doctor straight away. If you know you are allergic to an antibiotic, please discuss this with the OPAT consultant or the specialist nurse prior to commencing treatment.

Rarely patients may feel dizzy following administration of their intravenous antibiotics. If you develop dizziness following your treatment, please inform the OPAT specialist nurse straight away. You must not operate machinery or drive if you feel dizzy (stop driving immediately) or unable to concentrate.

If you have not received any intravenous antibiotic treatment in hospital prior to attending the OPAT clinic, it is strongly advised that you do not drive yourself to clinic or home following your first few treatments, until you know how your antibiotic therapy affects you.

Do antibiotics interact with other medications?

Antibiotics can usually be taken safely with most other medications. Sometimes antibiotics can interact with other medications and cause unwanted side effects. If you are taking other medications (including any herbal or complementary treatments) please tell the OPAT consultant or OPAT specialist nurse prior to commencing your treatment. This is very important if you take the contraceptive pill or warfarin.

Please advise the OPAT specialist nurse of any changes to your regular medications during your course of treatment. We will then inform you if you need to do anything different.

Do I have to continue with this type of care?

No, if after trying this type of care you find it is not right for you, please ask to discuss this with the OPAT specialist nurse.

Should you require further advice on the issues contained in this leaflet, or if you have any concerns during treatment, please do not hesitate to contact the OPAT specialist nurse  at Hull Royal Infirmary on Tel: 01482461072 8am to 4pm Monday to Friday.  Out of Hours please contact Ward 7 at Castle Hill Hospital on 01482468907.