Infectious Disease

Community-Based Parenteral Antimicrobial Treatment

Community-based parenteral antimicrobial therapy (CoPAT) is the administration of intravenous antibiotic therapy outside the hospital setting. Over the past 30 years this has become a widely accepted form of therapy, and about 1 out of 1000 Americans receive it every year. CoPAT has allowed for shorter hospitalizations, resulting in lower costs of healthcare, and even preventing hospitalization in some cases.

Cleveland Clinic has had a CoPAT program since 1979. All patients hospitalized at Cleveland Clinic require evaluation by an infectious disease staff physician before they can be discharged on CoPAT. The same staff physician follows each patient for the duration of his or her CoPAT. This practice serves an antimicrobial stewardship function at the time of transition of care from the inpatient setting to the community, and provides continuity of care from the inpatient to the outpatient setting with appropriate follow-up when needed.

Annual CoPAT Volumes at Cleveland Clinic

2014 - 2018

In the past 5 years, there have been more than 2500 CoPAT courses per year at Cleveland Clinic.

ED Visits, Readmissions, and Death Following CoPAT

2014 - 2018

CoPAT = community-based parenteral antimicrobial therapy, ED = emergency department

Not every CoPAT course concludes uneventfully. Some patients on CoPAT require a visit to an emergency department, which is an unanticipated and unwelcome event and constitutes use of an expensive component of the healthcare system. Some patients require hospitalization.

Infection Outcomes for Patients Treated With CoPAT at Cleveland Clinic

2013 - 2018

CoPAT = community-based parenteral antimicrobial therapy

Most CoPAT courses result in a successful outcome. Many “Undefined” outcomes are due to rehospitalization while still on CoPAT.