Outcomes of patients with a history of injecting drug use and receipt of outpatient antimicrobial therapy

O’Callaghan, Kevin; Tapp, Sam; Hajkowicz, Krispin; Legg, Amy; McCarthy, Kate

doi:10.1007/s10096-018-03461-3

Cited by 15 publications

(7 citation statements)

References 14 publications

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“…5 shows the details of the reviewed studies. The studies were published between 2001 and 2023; and were carried out in the United States (n = 21) [25,27,[32][33][34]36,37,40,[42][43][44][45][46][47]50,[53][54][55][56]58,59], United Kingdom (n = 6) [21,22,24,28,49,60], Australia (n = 6) [7,29,48,51,52,57], New Zealand (n = 3) [30,31,61], Switzerland (n = 3) [26,37,39], Germany (n = 1) [23],…”

Section: Selection Results and Characteristics Of The Studiesmentioning

confidence: 99%

Risk of venous thromboembolism in outpatient parenteral antimicrobial therapy (OPAT): A systematic review and meta-analysis

Durojaiye

Kritsotakis

2023

International Journal of Antimicrobial Agents

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Section: Selection Results and Characteristics Of The Studiesmentioning

confidence: 99%

Risk of venous thromboembolism in outpatient parenteral antimicrobial therapy (OPAT): A systematic review and meta-analysis

Durojaiye

Kritsotakis

2023

International Journal of Antimicrobial Agents

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“…Rates of central line tampering are low in available studies (0–2%), 17‐19 and no significant difference in rates of line infections have been noted 20,21 . While PWID may require more intensive support when receiving OPAT (including increased after‐hour nursing calls), 21 staff safety has been demonstrated 22 …”

Section: Provision Of Evidence‐based Treatment For People Who Inject ...mentioning

confidence: 99%

“… 20 , 21 While PWID may require more intensive support when receiving OPAT (including increased after‐hour nursing calls), 21 staff safety has been demonstrated. 22 …”

Section: Provision Of Evidence‐based Treatment For People Who Inject ...mentioning

confidence: 99%

Review of management priorities for invasive infections in people who inject drugs: highlighting the need for patient‐centred multidisciplinary care

Attwood

McKechnie

Vujovic

et al. 2022

Medical Journal of Australia

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Summary There has been a global increase in the burden of invasive infections in people who inject drugs (PWID). It is essential that patient‐centred multidisciplinary care is provided in the management of these infections to engage PWID in care and deliver evidence‐based management and preventive strategies. The multidisciplinary team should include infectious diseases, addictions medicine (inclusive of alcohol and other drug services), surgery, psychiatry, pain specialists, pharmacy, nursing staff, social work and peer support workers (where available) to help address the comorbid conditions that may have contributed to the patient’s presentation. PWID have a range of antimicrobial delivery options that can be tailored in a patient‐centred manner and thus are not limited to prolonged hospital admissions to receive intravenous antimicrobials for invasive infections. These options include discharge with outpatient parenteral antimicrobial therapy, long‐acting lipoglycopeptides (dalbavancin and oritavancin) and early oral antimicrobials. Open and respectful discussion with PWID including around harm reduction strategies may decrease the risk of repeat presentations with injecting‐related harms.

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“…We identified 289 patients with 333 eligible admissions during the study period in which an ID and addiction medicine team evaluation was performed during the same hospital encounter (Figure 1). The most common reasons for exclusion were infection treated less than 2 weeks (63), hardware infection (38), no infection identified (21), non-bacterial infection (19), and no active SUD (11). Three patients were excluded because journals.sagepub.com/home/tai TherapeuTic advances in infectious disease they had an ID note in the chart, but there was no direct patient contact.…”

Section: Descriptive Analysis: Cohort Characteristicsmentioning

confidence: 99%

“…Concerns for misuse of the peripherally inserted central catheter (PICC), non-adherence, and feasibility still remain, with current guidelines suggesting that decisions to treat PWID with OPAT be made on a case-bycase basis. [11][12][13] Infectious diseases (ID) providers note many obstacles in providing care for PWID with infections, which has led a number of institutions to establish tools to better incorporate SUD and infection treatment while optimizing safe discharges. 7,14,15 The importance of a multidisciplinary treatment approach has been recognized in a variety of complex infections.…”

Section: Introductionmentioning

confidence: 99%

Description and outcomes of patients with substance use disorder with serious bacterial infections who had a multidisciplinary care conference

Conte

Schneider

Varley

et al. 2022

Therapeutic Advances in Infection

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Background: Patients with substance use disorders (SUDs) and severe bacterial infections requiring prolonged antibiotic therapy represent a significant challenge to providers due to complexity of care coordination required to ensure safe and effective treatment. Our institution developed a patient-centered multidisciplinary discharge planning conference, OPTIONS-DC, to address this challenge. Methods: We conducted a retrospective review to evaluates parameters between patients who received an OPTIONS-DC and those who did not. Results: We identified 73 patients receiving an OPTIONS-DC and 100 who did not. More patients with an OPTIONS-DC were < 40 years of age (76.7% versus 61.0%, OR = 2.3, 95% CI = 1.1–4.7, p = 0.02), had positive HCV antibody testing (58.9% versus 41.0%, OR = 2.1, 95% CI = 1.1–3.8, p = 0.02), injection drug use (93.2% versus 79.0%, OR = 3.6 95% CI = 1.3–10.1, p = 0.01), used methamphetamines (84.9% versus 72.0%, OR = 2.2, 95% CI = 1.0–4.8, p = 0.04), and started inpatient SUD treatment (80.8% versus 63%, OR = 2.5, 95% CI = 1.2–5.0, p = 0.04) compared with those without a conference. The OPTIONS-DC group was more likely to be diagnosed with bacteremia (74.0% versus 57.0%, OR = 2.1, 95% CI = 1.1–4.1, p = 0.02), endocarditis (39.7% versus21.0%, OR = 2.5, 95% CI = 1.3–4.9, p = 0.03), vertebral osteomyelitis (45.2% versus 15.0%, OR = 4.7, 95% CI = 2.3–9.6, p < 0.01), and epidural abscess (35.6% versus 10.0%, OR = 5.0, 95% CI = 2.2–11.2, p < 0.01) and require 4 weeks or more of antibiotic treatment (97.3% versus 51.1%, OR = 34.1, 95% CI = 7.9–146.7, p = 0.01). Patients with an OPTIONS-DC were also more likely to be admitted between 2019 and 2020 than between 2018 and 2019 (OR = 4.1, 95% CI = 2.1–7.9, p < 0.01). Conclusion: Patients with an OPTIONS-DC tended to have more complicated infections and longer courses of antibiotic treatment. While further research on outcomes is needed, patients receiving an OPTIONS-DC were able to successfully complete antibiotic courses across a variety of settings.

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Outcomes of patients with a history of injecting drug use and receipt of outpatient antimicrobial therapy

Cited by 15 publications

References 14 publications

Risk of venous thromboembolism in outpatient parenteral antimicrobial therapy (OPAT): A systematic review and meta-analysis

Risk of venous thromboembolism in outpatient parenteral antimicrobial therapy (OPAT): A systematic review and meta-analysis

Review of management priorities for invasive infections in people who inject drugs: highlighting the need for patient‐centred multidisciplinary care

Description and outcomes of patients with substance use disorder with serious bacterial infections who had a multidisciplinary care conference

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