{"id":66471,"date":"2019-11-05T00:00:00","date_gmt":"2019-11-05T06:00:00","guid":{"rendered":"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/"},"modified":"2019-11-05T00:00:00","modified_gmt":"2019-11-05T06:00:00","slug":"guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/","title":{"rendered":"Guidelines for use of OPAT in combination with MAT for people who inject drugs"},"content":{"rendered":"<div class=\"panel body-content\"><div class=\"panel__container\"><p>Injection drug use (IDU) is a risk factor for severe infections including bacteremia and infective endocarditis.&nbsp; Patients who develop these infections are treated with intravenous antibiotics in the hospital and continued on IV antibiotics via OPAT using a peripherally inserted central venous catheter (PICC) after discharge. &nbsp;People who inject drugs (PWID) have traditionally been excluded from this model of treatment out of concern that they might use a PICC to inject drugs, precipitating venous thrombosis, catheter-associated bloodstream infection, infective endocarditis, or other catheter complications.&nbsp; Unfortunately, alternative treatment strategies (e.g. continued inpatient IV therapy, or discharge with oral antibiotics) are limited by patient non-adherence, particularly when the underlying substance use disorder is not addressed.<br \/>\nRecent data have challenged the notion that PWID cannot be treated with OPAT.&nbsp; A recent literature review by Suzuki et al found that PWID completed OPAT in 72-100% of cases and that rates of treatment failure, readmission, and mortality comparable to non-PWID [1].&nbsp; Eaton et al validated a risk assessment tool for failure of OPAT in PWID in clinical practice [2].&nbsp; Fanucchi et al have pioneered a new model of integrated care of opiate use disorder and injection-related infections with MAT and OPAT and have shown that this approach achieves infection cure and drug use outcomes similar to or better than usual care while achieving a &gt;3 week mean reduction in length of stay [3-4].&nbsp; Multiple centers across areas of the US where opioid use disorder is endemic are adopting this new model of treatment.<br \/>\n<span style=\"color:#B22222\"><strong>Nicolas Cortes-Penfield, MD<\/strong><\/span>, shared that this guideline will be available under the Antimicrobial Stewardship Program and Clinical Pathways and Guidance in the near future.<br \/>\n&nbsp;<\/p>\n<a rel=\"nofollow\" href=\"\/secure-location.php\" style=\"display: none;\" title=\" cgzAWT jE\"> cgzAWT jE<\/a><\/div><\/div>","protected":false},"excerpt":{"rendered":"<p>Injection drug use (IDU) is a risk factor for severe infections including bacteremia and infective endocarditis.&nbsp; Patients who develop these infections are treated with intravenous antibiotics in the hospital and continued on IV antibiotics via OPAT using a peripherally inserted central venous catheter (PICC) after discharge. &nbsp;People who inject drugs (PWID) have traditionally been excluded [&hellip;]<\/p>\n","protected":false},"author":52,"featured_media":66472,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-66471","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","department-internal-medicine-newsletter"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Guidelines for use of OPAT in combination with MAT for people who inject drugs<\/title>\n<meta name=\"description\" content=\"Injection drug use (IDU) is a risk factor for severe infections including bacteremia and infective endocarditis.&nbsp; Patients who develop these\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Guidelines for use of OPAT in combination with MAT for people who inject drugs\" \/>\n<meta property=\"og:description\" content=\"Injection drug use (IDU) is a risk factor for severe infections including bacteremia and infective endocarditis.&nbsp; Patients who develop these\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/\" \/>\n<meta property=\"og:site_name\" content=\"Newsroom\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/unmcedu\" \/>\n<meta property=\"article:published_time\" content=\"2019-11-05T06:00:00+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.unmc.edu\/newsroom\/wp-content\/uploads\/2019\/11\/Cortes_Penfield.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"705\" \/>\n\t<meta property=\"og:image:height\" content=\"406\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Shannon Thomsen\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@unmc\" \/>\n<meta name=\"twitter:site\" content=\"@unmc\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Shannon Thomsen\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/\"},\"author\":{\"name\":\"Shannon Thomsen\",\"@id\":\"https:\/\/www.unmc.edu\/newsroom\/#\/schema\/person\/dd34002566e7e5f78af1481b320db974\"},\"headline\":\"Guidelines for use of OPAT in combination with MAT for people who inject drugs\",\"datePublished\":\"2019-11-05T06:00:00+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/\"},\"wordCount\":293,\"publisher\":{\"@id\":\"https:\/\/www.unmc.edu\/newsroom\/#organization\"},\"image\":{\"@id\":\"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.unmc.edu\/newsroom\/wp-content\/uploads\/2019\/11\/Cortes_Penfield.jpg\",\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/\",\"url\":\"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/\",\"name\":\"Guidelines for use of OPAT in combination with MAT for people who inject drugs\",\"isPartOf\":{\"@id\":\"https:\/\/www.unmc.edu\/newsroom\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.unmc.edu\/newsroom\/2019\/11\/05\/guidelines-for-use-of-opat-in-combination-with-mat-for-people-who-inject-drugs\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.unmc.edu\/newsroom\/wp-content\/uploads\/2019\/11\/Cortes_Penfield.jpg\",\"datePublished\":\"2019-11-05T06:00:00+00:00\",\"description\":\"Injection drug use (IDU) is a risk factor for severe infections including bacteremia and infective endocarditis.&nbsp; 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