隨著抗藥性問題日益嚴重，抗生素管理已成為醫療品質與感染管制的重要議題。近年健保署推動門診靜脈抗生素治療(OPAT)獎勵方案，提供住院以外之選擇，以期減少住院需求並提升醫療可近性。本文從基層門診觀點出發，探討其制度設計、臨床應用及挑戰。基層診所可透過胸部X光、尿液培養及臨床評估進行初步診斷，使穩定感染病人得以於社區接受治療。然而，目前實務上仍面臨療程設計、抗生素劑型限制、專業支援需求及院外感染控制等議題。對此，本文提出建立示範診所、強化分級醫療轉診體系，並結合在宅急症照護與遠距監測等政策議。OPAT應定位為社區感染整合照護的重要模式，以兼顧抗生素管理與病人安全。

Under the growing threat of antimicrobial resistance, antimicrobial stewardship has become a key concern in healthcare quality and infection control. Recently, Taiwan’s National Health Insurance Administration launched an outpatient parenteral antimicrobial therapy (OPAT) incentive program to provide an alternative to inpatient care while reducing hospitalization requirements and enhancing healthcare accessibility. This article discusses the system design, clinical applications, and current challenges of OPAT from a primary care perspective. Primary care clinics may perform initial evaluations such as chest radiography, urine culture, and clinical assessments to enable patients with stable infections to receive community-based treatment. However, several practical challenges remain, including problems in treatment course design, limitations in antibiotic formulations, the need for specialist support, and difculties in infection control in outpatient settings. This study proposes several policy recommendations to address these challenges, including establishing demonstration clinics, strengthening the hierarchical referral system, and integrating home-based acute care into remote monitoring. OPAT should be positioned as an essential model for integrated community infection care to ensure both efective antimicrobial stewardship and patient safety.