Infectious Disease

Community-based Parenteral Antimicrobial Treatment

Community-based parenteral antimicrobial therapy (CoPAT) is the administration of intravenous antibiotic therapy outside the hospital setting. During the past 40 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 has even prevented 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 it provides continuity of care from the inpatient to the outpatient setting with appropriate follow-up when needed.

Annual CoPAT Volumes at Cleveland Clinic

2018 – 2022

CoPAT = community-based parenteral antimicrobial therapy

In the past 5 years, there have been more than 3000 CoPAT courses per year at Cleveland Clinic. The total number of CoPAT courses includes CoPAT courses at Avon Hospital since 2019, Marymount and Akron General Hospitals since 2020, and Cleveland Clinic Weston Hospital, Florida since 2022. CoPAT numbers for Avon Hospital and Marymount Hospital are aggregated with those for Main Campus.

Top 10 CoPAT Forms Diagnoses


These are the top 10 diagnoses for all CoPAT forms from Infectious Disease physicians at Cleveland Clinic Akron, Main Campus, and Medina in Ohio, and Weston, Florida locations.

*BSI = bloodstream infections, CoPAT = community-based parenteral antimicrobial therapy

ED Visits, Readmissions, and Death Following CoPAT*

2018 – 2022

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

*includes Avon Hospital, Main campus, and Marymount Hospital

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.