Complex Outpatient Antimicrobial Therapy (COpAT) 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.

View COpAT Infographics →

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)

Fax

Lab orders to RightFax

(310) 206-8181

Contact

Lynn Chan, PharmD, BCIDPCOpAT Pharmacy LeadLynnChan@mednet.ucla.edu
Daniel McConville, MS, BSN, RN, ACRNCOpAT NurseDMcConville@mednet.ucla.edu

IV to PO Antimicrobial Conversion

Consider switching in the following scenarios

1
Clinically improvingAfebrile for 24–48 h
2
Hemodynamically stableNo pressors; vitals stable
3
Tolerating oral intakeFunctioning GI tract, no malabsorption
4
Active oral optionSource controlled; susceptible organism
Drug PO dose Bioavailability Notes
High bioavailability
Levofloxacin750 mg q24h99%Separate from cations ≥2 h. QTc. Tendinitis: educate, document
Ciprofloxacin500–750 mg q12h70–80%Separate from cations ≥2 h. Lowest QTc risk of quinolones. Tendinitis: educate, document
Moxifloxacin400 mg q24h~90%Separate from cations ≥2 h. QTc. Tendinitis: educate, document
Linezolid600 mg q12h~100%Weekly CBC. Avoid MAOIs; caution if multiple serotonergic agents or frail. Consider TDM if >2 weeks
TMP-SMX1–2 DS tabs BID90–100%Weight-based dosing may be needed depending on syndrome. Monitor K+, SCr
Doxycycline100 mg q12h~90–100%Separate from cations. Photosensitivity; pill esophagitis (take upright with water)
Low to moderate bioavailability
Cephalexin1 g q8h~90%—
Amoxicillin1 g q8h70–90%—
Amoxicillin-clavulanate875/125 mg q12h70–90% (amoxicillin)Diarrhea common; improves with time. Consider TID if higher dose needed
Cefpodoxime200–400 mg q12h~50%Similar coverage to ceftriaxone
Cefuroxime axetil500 mg q12h~50%Similar coverage to ceftriaxone; not ideal for S. pneumoniae