Outpatient Parenteral Antimicrobial Therapy (OPAT) Service

DGRefHelp - NHS Dumfries & Galloway
NHS Dumfries and Galloway

The OPAT service provides 7-day cover for the delivery of intravenous (IV) antimicrobials and monitoring of patients on complex oral antibiotics across Dumfries & Galloway.

What We Offer

  1. Referrals from Primary Care
    • Nurse-Led Clinic –
      • Skin & Soft Tissue Infections (SSTI)
      • UTI with no suitable oral option
    • Assessment of patients with suspected SSTI.
    • Decision-making on the need for IV antimicrobials.
    • Daily reviews with step-down to oral antimicrobials when appropriate.
  2. Referrals from Secondary Care
    • We accept referrals for IV antimicrobial delivery and monitoring in patients with complex infections requiring prolonged treatment, including:
      • Bone and joint infections
      • Endocarditis
      • Other deep-seated infections
      • All patients are reviewed daily or weekly by OPAT nursing staff and discussed at the weekly OPAT MDT.
  3. Complex Oral Antimicrobial Monitoring
    • We monitor and review patients discharged on high-risk oral antimicrobials, including:
      • Linezolid
      • Fluoroquinolones
      • Doxycycline
      • Cotrimoxazole
      • Rifampicin
    • These patients are accepted following a referral to the Complex OPAT (COPAT) service.

Who to refer

We will accept direct referrals for:

  • Complicated skin and soft tissue infections (upper/lower limbs or face, e.g. erysipelas) – after an adequate trial of oral antibiotics.
  • Antibiotic-resistant lower urinary tract infections (LUTI) where IV therapy has been recommended by Microbiology.
  • Pyelonephritis or febrile UTIs unsuitable for oral treatment due to resistance or allergy.
  • Patient requirements:
    • Must have a working phone number.
    • Must be able to attend the clinic independently. 

How to Refer From Primary Care

  1. Phone OPAT Service on 01387 241111 or 241976 to discuss the patient and confirm appointment capacity.
  2. If an appointment is available, complete a SCI Gateway referral to DGRI...Infectious disease...General Highlighting OPAT as reason for referral.
  3. Ensure patient details (especially phone numbers) are accurate.
  4. The OPAT team will contact the patient directly to arrange an appointment.
    • If referred before 14:00, we will try to see the patient the same day (not guaranteed).
    • Otherwise, the appointment may be arranged for the following day.

Who not to refer

Please do not refer patients who:

  • Require medical assessment for possible admission.
  • Have pain out of proportion to clinical findings, rapidly progressing skin changes, or blistering lesions (possible necrotising fasciitis, DVT, vascular pathology).
  • Have unstable comorbidities (e.g. AKI, cardiac decompensation, uncontrolled diabetes).
  • Have current Clostridioides difficile infection.
  • Have peri-orbital cellulitis.
  • Meet two or more of the following criteria:
    • Temp ≥ 38°C
    • Systolic BP < 100 mmHg
    • Pulse > 90 bpm
    • Respiratory rate > 20/min
  • Have other acute medical problems requiring hospitalisation.

Editorial Information

Last reviewed: 18/11/2025

Next review date: 18/11/2027

Author(s): Audrey Morris.

Version: 1.0