Department of Medicine, Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA.
Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA.
J Am Coll Cardiol. 2024 Apr 9;83(14):1338-1347. doi: 10.1016/j.jacc.2024.01.034.
Drug use-associated infective endocarditis (DUA-IE) is a major cause of illness and death for people with substance use disorder (SUD). Investigations to date have largely focused on advancing the care of patients with DUA-IE and included drug use disorder treatment, decisions about surgery, and choice of antibiotics during the period of hospitalization. Transitions from hospital to outpatient care are relatively unstudied and frequently a key factor of uncontrolled infection, continued substance use, and death. In this paper, we review the evidence supporting cross-disciplinary care for people with DUA-IE and highlight domains that need further clinician, institutional, and research investment in clinicians and institutions. We highlight best practices for treating people with DUA-IE, with a focus on addressing health disparities, meeting health-related social needs, and policy changes that can support care for people with DUA-IE in the hospital and when transitioning to the community.
药物使用相关感染性心内膜炎(DUA-IE)是药物使用障碍(SUD)患者发病和死亡的主要原因。迄今为止的研究主要集中在改善 DUA-IE 患者的治疗,包括药物使用障碍治疗、手术决策以及住院期间抗生素的选择。从医院过渡到门诊治疗相对研究较少,通常是感染失控、持续使用药物和死亡的关键因素。在本文中,我们回顾了支持跨学科治疗 DUA-IE 患者的证据,并强调了需要进一步投资于临床医生、医疗机构和研究人员的领域。我们重点介绍了治疗 DUA-IE 患者的最佳实践,重点是解决健康差距、满足与健康相关的社会需求以及可以支持 DUA-IE 患者在医院和过渡到社区时的治疗的政策变化。