Ambulatory antimicrobial therapy for CAP in adults

Ambulatory antimicrobial therapy (also commonly known as outpatient parenteral antimicrobial therapy [OPAT] or hospital in the home [HITH]) has a limited role in the management of adults with community-acquired pneumonia (CAP) and is not routinely recommended. Patients with moderate- or high-severity CAP are at risk of deterioration and should generally be managed in hospital while they require parenteral antibiotics. When the patient is well enough to go home, a switch to oral therapy is usually appropriate; however, if there are no options for oral therapy (eg because of antibiotic resistance), ambulatory antimicrobial therapy may be suitable.

For selected residents of an aged-care facility, if treatment in hospital is not consistent with the patient’s goals of care, parenteral therapy can avoid transfer to hospital – see Parenteral therapy for CAP in residents of an aged-care facility.