Service
OPAT is a 7 day a week service offering IV antimicrobial delivery or monitoring of patients on complex oral antimicrobials across the Lothians. It is a nurse-led clinic for treatment of skin and soft tissue infections (SSTI) where patients are assessed, the need for IV antibiotics determined, patients reviewed daily and switched to appropriate oral antimicrobial treatment when ready.
The OPAT team also takes referrals from secondary care for antibiotic delivery and monitoring in patients with complex infections requiring prolonged courses of antibiotics. These can include patients with bone and joint infection, patients with endocarditis and patients with intra-abdominal infections as examples. All patients are reviewed by nursing staff daily or weekly and discussed in an infection MDT weekly meeting.
OPAT offers a complex oral antibiotic clinic, (COOPAT) for monitoring and reviewing patients taking Linezolid, fluoroquinolones, doxycycline, pristinamycin and rifampicin, as well as those on oral or IV anti-fungal medications. If patients are discharged from hospital on any of the above oral antibiotics or any oral anti-fungal medication, OPAT will accept a referral for review in the COOPAT clinic.
OPAT is based in WGH, and SJH for those resident in West Lothian. A base in East Lothian Community Hospital is coming soon.
OPAT may be able to offer solutions to transport difficulties: please discuss when referring. The nurses can also teach patients to self administer IV antibiotics reducing the need to travel.
C.M & K.McI 21-12-22
Who to refer:
From Primary care:
Patients with skin and soft tissue infections.
These patients should have had a course of appropriate oral antibiotics prior to attending OPAT where appropriate.
Patients with multi-resistant urine infections where microbiology advises intravenous therapy.
Please call and discuss any other infection that may require IV antibiotics and if the OPAT team is unable to assist then it can sign post to a service that may be able to do so.
From Secondary care:
Patients requiring prolonged antimicrobial therapy who are otherwise fit for discharge.
Patients discharged on a complex oral regime requiring monitoring.
Who not to refer:
– Patients who require medical assessment for potential admission – these patients should still be referred via medical admissions.
– Patients with pain out of proportion to skin changes or rapidly evolving/blistering changes (in case of significant alternative diagnoses such as necrotising fasciitis, DVT, major vascular issues).
– Patients with 2 or more of the following:
Temp 38°
Systolic BP < 100mmHg
Pulse > 90 bpm
Resp rate > 20
– Other medical problems requiring hospitalisation.
How to refer:
Primary Care
In the first instance please call OPAT 0131 537 2844 (WGH) or 01506 522215 (SJH) to discuss the patient and ascertain capacity for appointment. If an appointment is available a SCI Gateway referral should be completed and sent to OPAT.
Please ensure patient details are correct on the referral, and especially an up-to-date phone number. The nursing staff will contact patients directly to offer them an appointment time.
Where possible, patients will be seen on the same day if referred before 4pm, however this cannot be guaranteed and may, where appropriate, be offered an appointment the next day.
Secondary Care
For patients resident in Edinburgh City, East or Mid Lothian – please email
WGH.OPAT@nhslothian.scot.nhs.uk attaching the referral form available on the NHS Lothian intranet WGH OPAT page.
For patients resident in West Lothian – please email
SJH.OPAT@nhslothian.scot.nhs.uk attaching the referral form available on the NHS Lothian intranet St John’s OPAT page.
