Medication‐assisted treatment for hospitalized patients with intravenous‐drug‐use related infective endocarditis

Suzuki, Joji

doi:10.1111/ajad.12349

Cited by 45 publications

(37 citation statements)

References 14 publications

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“…As previously elaborated in a case-series for IDU-IE among PUID, their hospitalization is an important but often missed window of opportunity for medicationassisted therapy initiation. 11 These findings are in line with prior studies suggesting that PUID hospitalized for IDU-IE receive suboptimal addiction treatment. 12 An important finding in our study is the underutilization of transition to drug rehabilitation facilities.…”

Section: Discussionsupporting

confidence: 87%

Inconsistent Addiction Treatment for Patients Undergoing Cardiac Surgery for Injection Drug Use-Associated Infective endocarditis

Tiako

Hong

Mahmood

et al. 2019

Preprint

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Introduction: Cases of injection drug use-related infective endocarditis (IDU-IE) requiring surgery are rising in the setting of the current U.S. opioid epidemic. We thus aimed to determine the nature of addiction interventions in the perioperative period. Methods: This is a retrospective review of surgical IDU-IE from 2011 to 2016 at a tertiary care center in New Haven, Connecticut. The data collected included substances consumed recreationally, consultations by social work (SW), psychiatry, pharmacotherapy for addiction, and evidence of enrollment in a drug rehabilitation program upon discharge. Among patients with active drug use (ADU), we compared the 24-month survival of those who received at least one form of addiction intervention to that of those who did not. Results: Forty-two patients (75%) had active drug use. Among them, 22 used heroin. Forty-one patients (73.2%) saw SW, 17 (30.4%) saw psychiatry; 14 (25%) saw neither SW nor psychiatry. Twenty-one patients (37.5%) received methadone, 6 (10.7%) received buprenorphine, 1 (0.02%) received naltrexone; 26 (46.4%) did not receive any pharmacotherapy. Fifteen patients (26.8%) attended a drug rehabilitation program, 13 (86.7%) of whom had seen SW and 8 (53%) psychiatry. Among patients with ADU, there was no statistically significant difference in survival between those who received at least one intervention and those who did not (p=0.1 by log rank). Conclusion: Addiction interventions are deployed inconsistently for patients with surgical IDU-IE. Untreated substance use disorder and recurrent endocarditis are the leading cause of death in this population. Studying best-practices for perioperative interventions in IDU-IE and establishing protocols are of the upmost importance.

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Section: Discussionsupporting

confidence: 87%

Inconsistent Addiction Treatment for Patients Undergoing Cardiac Surgery for Injection Drug Use-Associated Infective endocarditis

Tiako

Hong

Mahmood

et al. 2019

Preprint

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“…However, there have been limited studies demonstrating the impact of OAT on the risk of deep tissue infections. Interestingly, other studies examining deep tissue infections among injection drug users call for enhanced access to addiction treatment to address the underlying causes of such infections [26,90,91]. Additional studies are needed to support our findings.…”

Section: Plos Onementioning

confidence: 63%

A retrospective cohort study evaluating correlates of deep tissue infections among patients enrolled in opioid agonist treatment using administrative data in Ontario, Canada

et al. 2020

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The objective of this study was to evaluate the relationship between individual characteristics and deep tissue infections in patients enrolled in opioid agonist treatment in Ontario, Canada. Methods A retrospective cohort study was conducted on patients in opioid agonist treatment between January 1, 2011, and December 31, 2015 in Ontario, Canada. Patients were identified using data from the Ontario Health Insurance Plan Database, and the Ontario Drug Benefit Plan Database. We identified other study variables including all-cause mortality using data from the Registered Persons Database. Encrypted patient identifiers were used to link across databases. Logistic regression models were used to measure potential correlates of deep tissue infections. Results An increase in the incidence of deep tissue infections was observed between 2011 and 2016 for patients on opioid agonist treatment. Additionally, age, sex, positive HIV diagnosis, and all-cause mortality was correlated with deep tissue infection in our study population. Conclusion The study indicates factors that are associated with deep tissue infections in the opioid use disorder population and can be used to identify opportunities to reduce the incidence of new infections.

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“…Prior studies have shown that hospitalizations represent important opportunities to initiate treatment and link to ongoing treatment after discharge [ 31–33 ]. Even though their hospital admission was not for the purpose of seeking addiction treatment, PWID often accept addiction treatment offered in the hospital [ 31 , 34 ]. In a study of 29 hospitalized patients with IDU-related endocarditis who were offered addiction psychiatry consultation, the majority (62%) accepted and initiated buprenorphine or methadone treatment during hospital admission [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Outpatient Parenteral Antimicrobial Therapy Among People Who Inject Drugs: A Review of the Literature

Suzuki

Johnson

Montgomery

et al. 2018

Open Forum Infectious Diseases

Self Cite

112

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Hospitalizations for people who inject drugs (PWID) with infectious complications requiring prolonged antibiotic therapy are increasing in the context of the opioid epidemic. Although outpatient parenteral antimicrobial therapy (OPAT) is routinely offered to patients without a history of injection drug use (IDU), PWID are often excluded from consideration of OPAT. To better assess the evidence base for the safety and effectiveness of OPAT for PWID, we conducted a review of the published literature. Results suggest that OPAT may be safe and effective for PWID, with rates of OPAT completion, mortality, and catheter-related complications comparable to rates among patients without a history of IDU. Rates of hospital readmissions may be higher among PWID, but instances of misuse of the venous catheter were rarely reported. More research is needed to study the safety and effectiveness of OPAT among PWID, as well as studying the combination of OPAT and addiction treatment.

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Medication‐assisted treatment for hospitalized patients with intravenous‐drug‐use related infective endocarditis

Abstract: The study provides preliminary support of engaging hospitalized IDU-IE patients to initiate MAT.

Cited by 45 publications

References 14 publications

Inconsistent Addiction Treatment for Patients Undergoing Cardiac Surgery for Injection Drug Use-Associated Infective endocarditis

Inconsistent Addiction Treatment for Patients Undergoing Cardiac Surgery for Injection Drug Use-Associated Infective endocarditis

A retrospective cohort study evaluating correlates of deep tissue infections among patients enrolled in opioid agonist treatment using administrative data in Ontario, Canada

Outpatient Parenteral Antimicrobial Therapy Among People Who Inject Drugs: A Review of the Literature

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