Date of this Version
Journal of Hospital Medicine Vol 11 No 8 August 2016
In the United States, there are an estimated 744,000 individuals who have engaged in recent injection drug use (IDU) and 6.6 million individuals who have ever injected a drug.1 The practice of IDU predisposes individuals to serious bacterial and fungal infections that often require long-term intravenous antibiotics. In individuals without IDU, these serious infections are often treated with outpatient parenteral antibiotic therapy (OPAT). However, a different standard exists for many persons who inject drugs (PWID)—the mandated completion of antibiotics in an inpatient setting.
Though mandating inpatient antibiotic therapy for PWID is a widely adopted standard, this practice is not evidence based and may increase overall costs to the healthcare system. In 2012, in a qualityimprovement initiative, UKHealthCare established a protocol for treating appropriate PWID with OPAT.2 They found very few inpatient providers willing to discharge PWID on OPAT, even with an established protocol.