Advocating for Personalized OPAT Monitoring to Improve Patient Care

As outpatient parenteral antimicrobial therapy (OPAT) programs continue to evolve, clinicians are rethinking the long-standing practice of routine weekly laboratory monitoring for every patient. Meera Mehta, PharmD, clinical infectious diseases pharmacist at West Virginia University Medicine in Morgantown, West Virginia, believes a more personalized approach can improve both patient care and convenience without compromising safety. Mehta is participating in a presentation at the MAD-ID and SIDP 2026 annual meeting around this topic.

Speaking about the limitations of standardized monitoring, Mehta explained that patients receiving OPAT differ significantly in age, comorbidities, infection type, and treatment regimen, making individualized care essential.

“I think that a one size fits all approach doesn't work because patients aren't all the same. They have different ages, different comorbidities, different infections that require different antibiotics,” Mehta said. “If we have antibiotics that are less toxic, I don't think it makes sense to monitor them the exact same way as antibiotics that are more toxic.”

Mehta noted that clinicians should evaluate several factors when deciding whether to reduce the frequency of laboratory testing, including renal and liver function, infection severity, duration of therapy, and the antimicrobial agent itself. She highlighted newer data suggesting that low-toxicity antibiotics such as cefazolin and ceftriaxone are associated with very low rates of abnormal laboratory findings during weekly monitoring.

Beyond clinical considerations, Mehta emphasized the importance of social determinants of health in OPAT management. Practicing in a rural setting, she frequently encounters patients who struggle with transportation, work obligations, or limited access to healthcare facilities, making weekly lab visits difficult.

Drawing on nearly a decade of experience building WVU Medicine’s OPAT program, Mehta said one of the most important lessons has been recognizing the need for patient-centered care that balances safety with practicality.

“I think that biggest lesson for me is to make sure that the patient is at the center and that we're doing what's safe, but we're doing what works for them as well,” Mehta said.

Mehta added that while standardized monitoring approaches were helpful during the early development of OPAT programs, growing experience and emerging evidence now support a more tailored strategy for select low-risk patients.