Antibiotic therapy completion for injection drug use-associated infective endocarditis at a center with routine addiction medicine consultation: a retrospective cohort study

BMC Infectious Diseases

Courtney Goodrich¹  Janice Weinberg²  Muhammad Dhanani³  Tamar F. Barlam⁴  Carlos Acuna-Villaorduna⁵ 

[1] Department of Biostatistics, School of Public Health, Boston University, 801 Massachusetts Avenue 3rd Fl., 02118, Boston, MA, USA;Department of Biostatistics, School of Public Health, Boston University, 801 Massachusetts Avenue 3rd Fl., 02118, Boston, MA, USA;Evans Center for Interdisciplinary Biomedical Research, Boston University, 700 Albany Street W601, 02118, Boston, MA, USA;Graduate Medical Sciences, Boston University School of Medicine, 72 East Concord Street, 02118, Boston, MA, USA;Section of Infectious Diseases, Department of Medicine, Boston Medical Center, 801 Massachusetts Avenue 2nd Fl., 02118, Boston, MA, USA;Division of Infectious Disease, Department of Medicine, Northwestern University, 645 N. Michigan Avenue Rm. 929, 60611, Chicago, IL, USA;Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, 801 Massachusetts Avenue 2nd Fl., 02118, Boston, MA, USA;Section of Infectious Diseases, Lemuel Shattuck Hospital, 170 Morton Street, 02130, Boston, MA, USA;Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, 801 Massachusetts Avenue 2nd Fl., 02118, Boston, MA, USA;

关键词: Endocarditis;    Injection drug use;    Opioid-related disorders;    Medications for opioid use disorder;   

DOI  :  10.1186/s12879-022-07122-x

来源: Springer

【 摘 要 】

BackgroundAddiction medicine consultation and medications for opioid use disorder are shown to improve outcomes for patients hospitalized with infective endocarditis associated with injection drug use. Existing studies describe settings where addiction medicine consultation and initiation of medications for opioid use disorder are not commonplace, and rates of antibiotic therapy completion are infrequently reported. This retrospective study sought to quantify antibiotic completion outcomes in a setting where these interventions are routinely implemented.MethodsMedical records of patients hospitalized with a diagnosis of bacteremia or infective endocarditis at an urban hospital between October 1, 2015 and December 31, 2017 were screened for active injection drug use within 6 months of hospitalization and infective endocarditis. Demographic and clinical parameters, receipt of antibiotics and medications for opioid use disorder, and details of re-hospitalizations within 1 year of discharge were recorded.ResultsOf 567 subjects screened for inclusion, 47 had infective endocarditis and active injection drug use. Addiction medicine consultation was completed for 41 patients (87.2%) and 23 (48.9%) received medications for opioid use disorder for the entire index admission. Forty-three patients (91.5%) survived to discharge, of which 28 (59.6%) completed antibiotic therapy. Twenty-nine survivors (67.4%) were re-hospitalized within 1 year due to infectious complications of injection drug use.ConclusionsAmong patients admitted to a center with routine addiction medicine consultation and initiation of medications for opioid use disorder, early truncation of antibiotic therapy and re-hospitalization were commonly observed.

【 授权许可】

CC BY