A Retrospective Cohort Study of Oral Antimicrobial Therapy Offers in Hospitalized People Who Inject Drugs Who Elect for Self-directed Discharge DOI
Christen J Arena,

Bryce Vanhorn,

Rachel M. Kenney

et al.

Journal of Addiction Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: March 17, 2025

Objectives: To evaluate infection management in people who inject drugs (PWID) elect for self-directed discharge (SDD) and to identify characteristics associated with an oral antimicrobial therapy offer (OATO). Methods: This was a retrospective cohort of hospitalized adult PWID injection drug use (IDU)-related elected SDD between January 1, 2014, 31, 2024, at five-hospital health system southeast Michigan. Patients were excluded if they <24 hours or treatment completed before SDD. The primary outcome the proportion patients OATO Secondary outcomes 30 days included retreatment, infection-related readmission, all-cause mortality. Results: One hundred fifty included; 55 (37%) received OATO, 95 (63%) did not receive offer. Patient different no groups: retreatment 19 (34%) versus 32 (34%); readmission 14 (25%) 31 (33%); mortality 1 (2%) 3 (3%). In multivariable logistic regression, variables independently prescribing/continuing medications opioid disorder (MOUD) (adjusted odds ratio [aOR], 2.8; 95% CI: 1.36–5.92), source control (aOR, 2.3; 1.10–4.84), early-career clinician care 1.01–7.89). Conclusions: Most IDU-related infections OATO. Early career clinicians more commonly offered antimicrobials less complicated types. Standardizing risk should be considered as future direction improve outcomes.

Language: Английский

A Retrospective Cohort Study of Oral Antimicrobial Therapy Offers in Hospitalized People Who Inject Drugs Who Elect for Self-directed Discharge DOI
Christen J Arena,

Bryce Vanhorn,

Rachel M. Kenney

et al.

Journal of Addiction Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: March 17, 2025

Objectives: To evaluate infection management in people who inject drugs (PWID) elect for self-directed discharge (SDD) and to identify characteristics associated with an oral antimicrobial therapy offer (OATO). Methods: This was a retrospective cohort of hospitalized adult PWID injection drug use (IDU)-related elected SDD between January 1, 2014, 31, 2024, at five-hospital health system southeast Michigan. Patients were excluded if they <24 hours or treatment completed before SDD. The primary outcome the proportion patients OATO Secondary outcomes 30 days included retreatment, infection-related readmission, all-cause mortality. Results: One hundred fifty included; 55 (37%) received OATO, 95 (63%) did not receive offer. Patient different no groups: retreatment 19 (34%) versus 32 (34%); readmission 14 (25%) 31 (33%); mortality 1 (2%) 3 (3%). In multivariable logistic regression, variables independently prescribing/continuing medications opioid disorder (MOUD) (adjusted odds ratio [aOR], 2.8; 95% CI: 1.36–5.92), source control (aOR, 2.3; 1.10–4.84), early-career clinician care 1.01–7.89). Conclusions: Most IDU-related infections OATO. Early career clinicians more commonly offered antimicrobials less complicated types. Standardizing risk should be considered as future direction improve outcomes.

Language: Английский

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