TY - JOUR
T1 - Antibiotic therapy completion for injection drug use-associated infective endocarditis at a center with routine addiction medicine consultation
T2 - a retrospective cohort study
AU - Dhanani, Muhammad
AU - Goodrich, Courtney
AU - Weinberg, Janice
AU - Acuna-Villaorduna, Carlos
AU - Barlam, Tamar F.
N1 - Funding Information:
An abstract describing preliminary findings of this work was published in Infection Control & Hospital Epidemiology after its presentation at the Society for Healthcare Epidemiology of America conference in 2020. No tables or figures were included with that abstract (https://doi.org/10.1017/ice2020.1071). This work was conducted with support from Boston University Clinical & Translational Science Institute (National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001430) and financial contributions from Boston University and its affiliated academic healthcare centers. The content is solely the responsibility of the authors and does not necessarily represent the official views of Boston University, its affiliated academic healthcare centers, or the National Institutes of Health.
Funding Information:
An abstract describing preliminary findings of this work was published in Infection Control & Hospital Epidemiology after its presentation at the Society for Healthcare Epidemiology of America conference in 2020. No tables or figures were included with that abstract ( https://doi.org/10.1017/ice2020.1071 ). This work was conducted with support from Boston University Clinical & Translational Science Institute (National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001430) and financial contributions from Boston University and its affiliated academic healthcare centers. The content is solely the responsibility of the authors and does not necessarily represent the official views of Boston University, its affiliated academic healthcare centers, or the National Institutes of Health.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: Addiction 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. Methods: Medical 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. Results: Of 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. Conclusions: Among 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.
AB - Background: Addiction 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. Methods: Medical 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. Results: Of 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. Conclusions: Among 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.
KW - Endocarditis
KW - Injection drug use
KW - Medications for opioid use disorder
KW - Opioid-related disorders
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U2 - 10.1186/s12879-022-07122-x
DO - 10.1186/s12879-022-07122-x
M3 - Article
C2 - 35123439
AN - SCOPUS:85124438281
VL - 22
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
SN - 1471-2334
IS - 1
M1 - 128
ER -