Just weeks after discharge, the patient is back at the hospital. This time, the infection has worsened, sepsis has set in, and emergency surgery is needed. A preventable outcome had intervention come sooner.
This scenario highlights a key risk of outpatient parenteral antimicrobial therapy (OPAT), which provides intravenous antibiotics to patients who need prolonged treatment but not hospitalization for infections such as osteomyelitis, diabetic foot infections, pneumonia, endocarditis or infections caused by drug-resistant organisms. While OPAT offers convenience, gaps in care can turn a routine infection into a life-threatening emergency.
UAB’s Complex OPAT (COPAT) program, led by Daniela de Lima Corvino, M.D., assistant professor in the Division of Infectious Diseases, has been working diligently to close care gaps and improve patient outcomes.
Established in 2016, the program began with a small team—a physician, a registered nurse, and a data specialist—who tackled common challenges of antimicrobial therapy. These included managing side effects such as drug toxicity, which occurs when excessive medication accumulates in the bloodstream, potentially causing dizziness, nausea, stomach pain, heart issues, muscle twitches, and seizures. The team also monitored patients’ treatment adherence and conducted follow-ups to identify potential complications.
“Side effects are common in antimicrobial therapy,” de Lima Corvino said. “If a patient stops taking the medication without informing the care team, complications may go unnoticed for up to six weeks, potentially leading to readmission or additional surgery.”
The Road to Improving Patient Outcomes
Over the years, the team has expanded to enhance the program’s effectiveness. Leaders attribute its accomplishments to collaboration, with advanced multidisciplinary care and partnerships across UAB driving the program’s most significant advancements in the past two years.
In 2023, the COPAT program added pharmacist Christin Tanner, Pharm.D., to improve medication management and toxicity assessments. Since joining the team, she has reduced the need for prolonged hospital stays by providing patients the opportunity to safely complete their antibiotic therapies at home. In her role, she follows patients from hospitalization to outpatient care, ensuring continuity of care and proactively adjusting treatments to minimize side effects and reduce readmissions.
Through her efforts, Tanner has successfully cared for over 1,400 patients and safely transitioned patients to oral antibiotics, reducing IV therapy by 568 days.
"I’ve been able to see firsthand how consistent monitoring and individualized care can make a significant difference in not only immediate patient outcomes but also in long-term health," explained Tanner. "It has been incredibly rewarding to be part of the team, and I’m excited to see continued growth."
The program also welcomed advanced practice provider Cherita Garcia, PA-C, who standardized follow-up care to ensure all COPAT patients receive a two-week post-discharge check-in, many via telemedicine. This approach has improved patient monitoring and has enhanced early complication detection.
Additionally, the program has strengthened partnerships with teams within the UAB Health System, like the UAB Antibiotic Stewardship Program, which ensures the proper use of antimicrobials—including antibiotics, antifungals, and antivirals—and the UAB Care Transition Team, which has been instrumental in bridging communication gaps with external facilities.
“There’s an intense, often unseen effort behind COPAT,” de Lima Corvino said. “I’m incredibly grateful and proud of our team’s dedication. Their work has improved patient outcomes, reduced readmissions, and enhanced satisfaction for both patients and providers.”
The COPAT program exemplifies UAB’s commitment to advancing patient care through collaboration and innovation. It serves as a model for how specialized care can drive better outcomes.