Outpatient parenteral antimicrobial therapy … and other research

Tom Nolan reviews this week’s research When it comes to peripherally inserted lines for outpatient parenteral antimicrobial therapy (OPAT), where should one draw the line? Midline catheters, which end in peripheral veins, are thought to offer lower risks of infection and thromboembolism than peripherally inserted central catheters (PICCs). A new cohort study supports this, finding that, for a device dwell of 14 days or less, midline catheters were associated with a lower risk of major complications (0.9% v 5.3%, adjusted hazard ratio 0.29 (95% CI 0.12 to 0.68)). However, the study design means that confounding by indication—whereby lower risk patients received a midline catheter—is hard to measure and exclude. JAMA Intern Med doi:10.1001/jamainternmed.2024.5984 Don’t wait until after prostate cancer diagnosis to consider life expectancy, advises an editorial …