• Reference Number: HEY1584/2025
• Departments: Infection Prevention and Control
• Last Updated: 31 July 2025

Introduction

This leaflet provides information about the oral antibiotic monitoring clinic. It is not intended to replace discussion between your medical team. Please discuss with your doctor or nurse if you have any concerns or require further explanation after reading.

What is OPAT?

The OPAT team can provide antibiotics into a vein (intravenously) to outpatients. This is provided in a clinic setting to patients who are well enough to be at home. OPAT also provides a service to monitor patients who are taking certain antibiotics orally. It is an alternative to receiving treatment in hospital and allows the patient to be recover in their own home.

Why do I need monitoring on oral antibiotics?

Traditionally, many complex infections were treated using long courses of intravenous antibiotics. Evidence now shows that for many of these infections; oral antibiotics are just as effective. Oral antibiotics can still have side effects. These are often more common with longer courses of treatment. Our service aims to make sure that problems are picked up early and acted upon if a treatment change is needed.

What are the benefits?

• Reduces your length of hospital stay
• Allows you to recover in your own home
• Helps to pick up antibiotic side-effects early and to improve patient safety

What are the risks?

• Some patients can have allergic reactions to antibiotics, but this is uncommon.
• Sometimes antibiotics can cause side effects, including problems with blood tests (most commonly kidney tests or full blood counts). These can usually be managed in the community but rarely need hospital admission.

Who will check my blood tests?

Your blood tests will be carried out by the OPAT nurses.  Most patients require blood tests weekly. Sometimes tests are done more or less often depending on your usual blood test results, the infection you have and the type of antibiotic. A member of the OPAT team (doctor, specialist pharmacist or specialist nurse) will review the results and advise on when the bloods next need checking.

Which antibiotics need monitoring?

Linezolid: Linezolid is an antibiotic prescribed under specialist guidance. For most patients, it works just as well orally as when given intravenously. It can cause problems with blood tests and needs weekly monitoring (most often anaemia or low platelets). This typically improves on stopping treatment.

Linezolid can cause other side effects such as nausea, fatigue, and a sore mouth. Very rarely, it can cause visual problems. You should report any changes in your eyesight to the OPAT team. Linezolid can interact with other medications; your doctor will have checked this prior to prescribing. It is important to let the prescriber and OPAT know if you start any new medication whilst taking linezolid.

Linezolid is approved for use up to 4 weeks. Some patients need longer treatment than this. We often find with close monitoring; patients can safely complete longer courses of linezolid avoiding the need for intravenous antibiotics.

Co-trimoxazole: Co-trimoxazole is an antibiotic that is used for many types of infection. Although most patients manage to take it without problems, it can cause anaemia. This is more common with longer treatment courses. In some patients (particularly older patients and those with kidney problems), it can also cause an increased potassium level. If left undetected high potassium levels can cause problems with the heart rhythm. We offer blood testing to pick up any problems early and act on them as needed.

Others:

Other antibiotics may also be monitored as advised by the infection doctors. Most patients also have their infection markers monitored to guide treatment plan.

What if I feel unwell at home?

If you are worried about feeling unwell because of the antibiotics or because your infection is not improving, please contact the OPAT team. In an emergency call 999.

Symptoms to report to nursing team:

• Nettle rash (hives)
• Vomiting or diarrhoea or abdominal pain
• High temperature
• Sudden dizziness or light headedness

In very rare cases, some people may have an extreme allergic reaction to their medication. This is called anaphylaxis.

• Swelling of throat and mouth
• Difficulty in swallowing or speaking.

If you experience any anaphylaxis symptoms either during or after taking your medicine stop your antibiotics. You should urgently dial 999 and explain that you think you may be having a serious allergic reaction to your antibiotic.

Contact information.

• OPAT team on tel: 01482 461072 Monday to Friday 08.00 to 16.00.
• Out of OPAT clinic hours if urgent contact the ID ward at Castle Hill Hospital on tel: 01482 468907.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.