Evidence map›Paper›PMID 41419216›Full record

Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026

Using the Comparing Oral versus Parenteral Antimicrobial Therapy (COPAT) Clinical Trial to Influence Institutional Practice Transformation Towards Earlier Transition to Oral Antibiotics.

Joy J Juskowich, Jesse M Thompson, Seyoum D Bage, Karen M Palmateer, John A Guilfoose, Allison M Lastinger, Connie L Smith, Victor A Arcega, Jonathan E Stanley, Haley M Summerfield and 4 more

2 registry-linked trialsAbstract readRandomized Controlled TrialComparative StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05977868 phase4terminatednot on this map

Comparing Oral Versus Parenteral Antimicrobial Therapy (COPAT) Trial

TypeinterventionalSponsorWest Virginia UniversityRan2023 to 2025Enrolled94ConditionsEndovascular Infection, Bone and Joint Infection, Skin and Soft Tissue Infection, Pulmonary InfectionArmsAmoxicillin, amoxicillin-clavulanate, cefadroxil, cefpodoxime, cefalexin, ciprofloxacin, delafloxacin, doxycycline, levofloxacin, linezolid, Ampicillin, ampicillin-sulbactam, cefazolin, cefepime, ceftaroline, ceftazidime, ceftazidime-avibactam, dalbavancin, daptomycin, ertapenem
NCT07148960 phase4enrolling by invitationnot on this map

Does Staphylococcus Aureus Bacteremia Early Dual Therapy Improve Outcomes? (SABEDTIO) Clinical Trial

TypeinterventionalSponsorWest Virginia UniversityRan2025 to 2027Enrolled300ConditionsStaphylococcus Aureus BacteremiaArmsEarly Dual IV Antibiotic Therapy - MRSA, Early Dual IV Antibiotic Therapy - MSSA, Single Agent IV Antibiotic Therapy - MRSA, Single Agent IV Antibiotic Therapy - MSSA
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Observational
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Joy J JuskowichWest Virginia University, Morgantown, West Virginia, USA.ORCID 0000-0001-8358-087X
Jesse M ThompsonWest Virginia University, Morgantown, West Virginia, USA.ORCID 0000-0003-0639-033X
Seyoum D BageWest Virginia University Medicine, Parkersburg, West Virginia, USA.
Karen M PalmateerWest Virginia University Medicine, Parkersburg, West Virginia, USA.
John A GuilfooseWest Virginia University Medicine, Morgantown, West Virginia, USA.ORCID 0009-0001-3057-1483
Allison M LastingerWest Virginia University Medicine, Morgantown, West Virginia, USA.
Connie L SmithUniversity of North Carolina Health, Rocky Mount, North Carolina, USA.ORCID 0009-0006-8599-7787
Victor A ArcegaWest Virginia University Medicine, Wheeling, West Virginia, USA.ORCID 0000-0001-8375-8973
Jonathan E StanleyWest Virginia University Medicine, Bridgeport, West Virginia, USA.
Haley M SummerfieldWest Virginia University Medicine, Bridgeport, West Virginia, USA.
Cynthia Fisher-DudaWest Virginia University, Morgantown, West Virginia, USA.
Manoj NepalMorgantown, West Virginia, USA.
Sijin WenWest Virginia University, Morgantown, West Virginia, USA.
Arif R SarwariWest Virginia University, Morgantown, West Virginia, USA.

Funding

West Virginia Clinical and Translational Science InstituteWest Virginia University Department of Medicine
6 · The paper itself

Abstract

backgroundExtensive literature has established equivalent efficacy of early intravenous (IV) to oral antibiotic transition. However, there is variability in adoption across practice settings. Unlike Outpatient Parenteral Antimicrobial Therapy (OPAT) programs, Complex Outpatient Antimicrobial Therapy with Oral Agents (COpAT) programs face significant implementation science challenges. We used a clinical trial with broad enrollment criteria to determine the impact of early oral transition in a real-world setting and studied its influence on practice transformation.

methodsComparing Oral versus Parenteral Antimicrobial Therapy (COPAT) Trial was a pragmatic, randomized controlled trial at 5 hospitals in 1 rural health system. Patients who required 2 or more weeks of IV antibiotics (for all but central nervous system infections) were randomized 2:1 to experimental (early-oral) group or control (IV-only) group. Two primary outcomes and hypotheses were assessed at 3 months: early-oral group safety superiority and efficacy equivalence. Clinical cases of patients who completed the trial were presented at multiple forums.

resultsThe trial was stopped early after two-thirds enrollment for a significant safety benefit. Early-oral group demonstrated a significantly lower adverse event rate (3.2% versus 6.5%, P = .02). Lower cumulative hazard for first study-related adverse event in early-oral group (hazard ratio, 0.24; 95% confidence interval, .08-.75; P = .01) appeared to emerge by day 10. Therapeutic efficacy was equivalent. Cumulative enrollment in the trial had a significant association with the COpAT:OPAT program consult ratio (R2= 0.54, P < .001).

conclusionsEarly oral antibiotic transition was significantly safer. At our academic health system, implementation of the COPAT Trial accelerated practice transformation. CLINICAL TRIALS REGISTRATION: NCT05977868.

Indexed as

Anti-Bacterial AgentsAdministration, IntravenousAdministration, OralAdultAgedFemaleHumansMaleMiddle AgedTreatment OutcomeAnti-Bacterial AgentsCOpAT programCOPAT Trialimplementation scienceoral antibioticspractice transformation

Identifiers

PMID41419216
PMCPMC13131940

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.