Sociodemographic and clinical factors associated with acceptance of outpatient parenteral antibiotic therapy in a Singapore tertiary hospital from 2014 to 2017

  • Liang En WeeEmail author
  • Mangaikarasi Sundarajoo
  • Way-Fang Quah
  • Ahmad Farhati
  • Jie-ying Huang
  • Ying-Ying Chua
Original Article


Outpatient parenteral antibiotic therapy (OPAT) can facilitate early discharge; however, not all offered OPAT can accept. We assessed factors associated with acceptance of OPAT in a large Asian tertiary hospital cohort. From 2014 to 2017, we reviewed all referrals to Singapore General Hospital’s (SGH) Outpatient Parenteral Antibiotic Therapy (OPAT) service. We compared differences in sociodemographic and clinical factors between patients who opted for OPAT and those who declined, using chi-square test for univariate analysis and logistic regression for multivariate analysis. From 2014 to 2017, a total of 1406 OPAT referrals were made. Of these, 95.9% (1349/1406) were deemed suitable for OPAT. Amongst those suitable, 90.0% (1213/1349) accepted OPAT treatment. On multivariate analysis, being independently ambulant (aOR = 3.46, 95%CI = 2.21–5.37) was independently associated with higher odds of acceptance for OPAT; whereas, patients with peripheral vascular disease had lower odds of accepting OPAT (aOR = 0.32, 95%CI = 0.16–0.62). Lower socioeconomic status (SES) was closely associated with rejection of OPAT, with markers of both individual-level SES (subsidized ward class) and area-level SES (staying in a public rental flat) being independently associated with lower odds of OPAT preference. Distance and travel time were not associated with OPAT acceptance. The top reasons for rejecting OPAT were lack of caregiver (n = 35), mobility issues (n = 24), financial issues (n = 24), and difficulty caring for the line (n = 21). Comorbidities, mobility, and financial issues are important factors to consider when determining suitability for OPAT. More can be done to improve accessibility of OPAT amongst lower-income patients and those staying in lower-SES areas.


Outpatient parenteral antibiotic therapy Socioeconomic Acceptability 


Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.

Ethical approval

This study involved human participants and was approved by the Singhealth Institutional Review Board (IRB) (approval number: CIRB 2014/151/F). Approval for retrospective analysis of patient data was obtained from the Singhealth IRB.

Informed consent

Waiver of informed consent for retrospective analysis of patient data was obtained from the Singhealth IRB.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Adjunct Research FellowDuke-NUS Graduate Medical SchoolSingaporeSingapore
  2. 2.Department of Infectious DiseasesSingapore General HospitalSingaporeSingapore

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