Evaluation of Partial Oral Antibiotic Treatment for Persons Who Inject Drugs and Are Hospitalized With Invasive Infections.
Clin Infect Dis
; 71(10): e650-e656, 2020 12 17.
Article
em En
| MEDLINE
| ID: mdl-32239136
ABSTRACT
BACKGROUND:
Persons who inject drugs (PWID) are at risk of invasive infections; however, hospitalizations to treat these infections are frequently complicated by against medical advice (AMA) discharges. This study compared outcomes among PWID who (1) completed a full course of inpatient intravenous (IV) antibiotics, (2) received a partial course of IV antibiotics but were not prescribed any antibiotics on AMA discharge, and (3) received a partial course of IV antibiotics and were prescribed oral antibiotics on AMA discharge.METHODS:
A retrospective, cohort study of PWID aged ≥18 years admitted to a tertiary referral center between 01/2016 and 07/2019, who received an infectious diseases consultation for an invasive bacterial or fungal infection.RESULTS:
293 PWID were included in the study. 90-day all-cause readmission rates were highest among PWID who did not receive oral antibiotic therapy on AMA discharge (nâ =â 46, 68.7%), compared with inpatient IV (nâ =â 43, 31.5%) and partial oral (nâ =â 27, 32.5%) antibiotics. In a multivariate analysis, 90-day readmission risk was higher among PWID who did not receive oral antibiotic therapy on AMA discharge (adjusted hazard ratio [aHR],â 2.32; 95% confidence interval [CI], 1.41-3.82) and not different among PWID prescribed oral antibiotic therapy on AMA discharge (aHR,â .99; 95% CI, .62-1.62). Surgical source control (aHR,â .57; 95% CI, .37-.87) and addiction medicine consultation (aHR,â .57; 95% CI, .38-.86) were both associated with reduced readmissions.CONCLUSIONS:
Our single-center study suggests access to oral antibiotic therapy for PWID who cannot complete prolonged inpatient IV antibiotic courses is beneficial.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Preparações Farmacêuticas
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Abuso de Substâncias por Via Intravenosa
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Usuários de Drogas
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article