Complex Outpatient
Antimicrobial Therapy
(COpAT) Program

Resources

COpAT Dosing and Monitoring Guidelines→HS IC 020 View COpAT Infographics→PDF

About the Program

Overview

COpAT lets patients continue complex oral and intravenous antimicrobial regimens outside the hospital, with close monitoring and follow-up. At UCLA Health, the COpAT team coordinates follow-up visits and safe lab monitoring so patients can finish treatment at home, in clinic, at a dialysis center, or in a skilled nursing facility. This means shorter hospital stays and lower costs, including for multidrug-resistant infections and conditions such as endocarditis and osteomyelitis.

Program Goals

  • Deliver safe, cost-effective, high-quality care for patients discharged on IV antimicrobials
  • Prevent unnecessary readmissions and worsened infection
  • Reduce the 30-day readmission rate and improve care in patients discharged with IV antibiotics

Service Locations

  • Patient's home, with a home health company and home infusion company
  • Skilled nursing facilities
  • Hemodialysis units
  • UCLA Health Clinics (Evaluation & Treatment Center, Santa Monica)

Contact

Lynn ChanPharmD, BCIDPCOpAT Pharmacy LeadLynnChan@mednet.ucla.edu

Daniel McConvilleMS, BSN, RN, ACRNCOpAT NurseDMcConville@mednet.ucla.edu

FaxLab orders to RightFax(310) 206-8181

IV to PO Antimicrobial Conversion

Consider switching in the following scenarios

  • Clinically improvingAfebrile for 24–48 h
  • Hemodynamically stableNo pressors; vitals stable
  • Tolerating oral intakeFunctioning GI tract, no malabsorption
  • Active oral optionSource controlled; susceptible organism
Drug PO dose Bioavailability Notes
High bioavailability
Levofloxacin DOSE 750 mg q24h BIOAVAILABILITY 99% Separate from cations ≥2 h. QTc. Tendinitis: educate, document
Ciprofloxacin DOSE 500–750 mg q12h BIOAVAILABILITY 70–80% Separate from cations ≥2 h. Lowest QTc risk of quinolones. Tendinitis: educate, document
Moxifloxacin DOSE 400 mg q24h BIOAVAILABILITY ~90% Separate from cations ≥2 h. QTc. Tendinitis: educate, document
Linezolid DOSE 600 mg q12h BIOAVAILABILITY ~100% Weekly CBC. Avoid MAOIs; caution if multiple serotonergic agents or frail. Consider TDM if >2 weeks
TMP-SMX DOSE 1–2 DS tabs BID BIOAVAILABILITY 90–100% Weight-based dosing may be needed depending on syndrome. Monitor K+, SCr
Doxycycline DOSE 100 mg q12h BIOAVAILABILITY ~90–100% Separate from cations. Photosensitivity; pill esophagitis (take upright with water)
Low to moderate bioavailability
Cephalexin DOSE 1 g q8h BIOAVAILABILITY ~90% —
Amoxicillin DOSE 1 g q8h BIOAVAILABILITY 70–90% —
Amoxicillin-clavulanate DOSE 875/125 mg q12h BIOAVAILABILITY 70–90% (amoxicillin) Diarrhea common; improves with time. Consider TID if higher dose needed
Cefpodoxime DOSE 200–400 mg q12h BIOAVAILABILITY ~50% Similar coverage to ceftriaxone
Cefuroxime axetil DOSE 500 mg q12h BIOAVAILABILITY ~50% Similar coverage to ceftriaxone; not ideal for S. pneumoniae