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Review of management priorities for invasive infections in people who inject drugs: highlighting the need for patient-centred multidisciplinary care

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posted on 2022-10-20, 03:57 authored by LO Attwood, M McKechnie, O Vujovic, Peter HiggsPeter Higgs, M Lloyd-Jones, JS Doyle, AJ Stewardson
There has been a global increase in the burden of invasive infections in people who inject drugs (PWID). It is essential that patient-centred multidisciplinary care is provided in the management of these infections to engage PWID in care and deliver evidence-based management and preventive strategies. The multidisciplinary team should include infectious diseases, addictions medicine (inclusive of alcohol and other drug services), surgery, psychiatry, pain specialists, pharmacy, nursing staff, social work and peer support workers (where available) to help address the comorbid conditions that may have contributed to the patient’s presentation. PWID have a range of antimicrobial delivery options that can be tailored in a patient-centred manner and thus are not limited to prolonged hospital admissions to receive intravenous antimicrobials for invasive infections. These options include discharge with outpatient parenteral antimicrobial therapy, long-acting lipoglycopeptides (dalbavancin and oritavancin) and early oral antimicrobials. Open and respectful discussion with PWID including around harm reduction strategies may decrease the risk of repeat presentations with injecting-related harms.

Funding

The authors acknowledge the work of Thuy Bui and Kelly Cairns for their assistance reviewing the pharmacology in this article. The Burnet Institute acknowledges support from the Victorian Government Operational Infrastructure Fund. Lucy Attwood receives postgraduate support from the Australian National Health and Medical Research Council (NHMRC). Joseph Doyle and Andrew Stewardson receive Fellowship support from the NHMRC.

History

Publication Date

2022-07-18

Journal

Medical Journal of Australia

Volume

217

Issue

2

Pagination

8p. (p. 102-109)

Publisher

John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.

ISSN

0025-729X

Rights Statement

© 2022 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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