To optimise care for our patients, TTSH’s Antimicrobial Stewardship Programme looks at:
- Institutional guidelines for appropriate use of antibiotics
- Computer-based surveillance of antibiotic usage, resistance, and incidence of multi-drug-resistant organisms; and
- Computerised decision support system in guiding appropriate antibiotic prescribing
The Blood Culture Service recommends appropriate antibiotic, dose, frequency, route, duration, further investigation and referral, thereby aims to:
- Optimise empiric antibiotic therapy for bacteraemia in the first 24 hours
- Optimise culture-guided definitive antibiotic therapy for bacteraemia in the first 48 hours using the most appropriate narrow-spectrum effective antibiotic
- Guide appropriate initial investigation and management of bacteraemia and fungaemia, including recommendation for referral to Infectious Diseases
IMI engages all stakeholders in ICU for consensus and guideline driven management of patients with difficult ID issues, and to optimise antimicrobial therapy.
The IMI team adopts a dedicated, multi-disciplinary approach, to engage, empower and support the attending team of ICU. IMI:
- provides advisory service on antibiotic usage,
- provides 2-way discussion on the management of the patient
- engage the junior doctors so that they would understand the rationale behind the management
- inputs on consensus, evidence-based medicine
The Dept of ID provides travel medicine services in the Travellers' Health and Vaccination Clinic (THVC), which enhances the health of travellers by:
- Striving for continued excellence in travel medicine consultations and care
- Providing excellence in service
- Promoting knowledge in travel medicine in healthcare & professional communities
- Increasing public awareness on the need for travel medicine
- Encouraging research to further knowledge in the field of travel medicine
What is OPAT?
OPAT, Outpatient Parenteral Antibiotic Therapy, is an outpatient support service that allows you to continue your course of intravenous antibiotic treatment prescribed by your doctor in Tan Tock Seng Hospital's OPAT clinic or in your own home. OPAT clinic offers patients the opportunity to complete their antibiotic treatment safely and conveniently without overnight stay in hospital.
What to Expect Before Your OPAT Treatment?
- A doctor's referral to OPAT
- Assessment by an OPAT doctor for your suitability for the treatment
- If you are a suitable candidate, an OPAT nurse will proceed to advise you on important information related to your treatment, such as treatment charges, Medisave claims, follow-up visits and more.
What Will You Need for Your OPAT Treatment?
- Peripherally Inserted Central Catheter (PICC) - A special tubing that is usually inserted through a vein in your arm. Treatment using a PICC reduces the risk of infection as compared to using an intravenous cannula insertion.
- Antibiotic - Your antibiotic prescription will be specially prepared for administration via the PICC. During treatment, you are free to resume your normal routine.
- Hospitalisation leave - You will be issued hospitalisation leave during the course of your treatment.
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What are the Potential Risks and Their Preventive Measures?
The risks you may experience are:
1. The infection you are being treated for may deteriorate during the course of your OPAT treatment.
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Management
- You may be re-admitted to the hospital for further management if necessary.
2. You may develop rashes, nausea or diarrhea from the antibiotics administered.
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Management
- You may require a change of antibiotics or re-admission to hospital
- The first dose of your antibiotics will be administered in the hospital. This is to ensure that there are no serious side effects
- A weekly blood test will be taken to monitor for any side effects to your blood count, kidney or liver function, and to assess your response to the antibiotic treatment
3. Your PICC may become clogged, infected (Pain / Fever / Redness / Swelling / Discharged), dislodged.
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Management
- A radiology specialist will assist to clear the blockage
- For early detection of possible infection, PICC sites will be inspected each time you return for a visit.
How Often do I Need to Return for Check-ups?
- Your OPAT nurse will arrange appointments for you to return for your regular reviews depending on the antibiotics prescribed. This usually happens on a daily or alternate-day basis and includes weekends and public holidays.
- The doctor will also see you every week (Mondays or Tuesdays) or when the nurse detects a possible problem.
What Happens After I Complete My OPAT Treatment?
- An appointment will be arranged for you to see either your doctor who referred you to OPAT or an Infectious Disease Specialist for follow-ups.
- You may also be required to undergo blood tests and X-ray investigations, and be given oral antibiotics when you return for your review.
Can I use My Medisave to pay for OPAT Treatments?
- Yes, you may use your Medisave to pay for certain OPAT treatment charges. This is subjected to an annual cap established by the Ministry of Health and any other applicable regulations.
- You may check with the OPAT nurse if you have any enquiries.
If you have any problem with your treatment, please contact your doctor, pharmacist or nurse clinician.
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Pre-Discharged Vaccination Programme (PVD) is a collaborative project between
TTSH Pharmacy & Department of ID to improve vaccination uptake for TTSH inpatients who need vaccination against influenza and Streptococcus pneumonia.
