Outcomes of Outpatient Parenteral Antibiotic Treatment of Persons Who Inject Drugs Discharged With Central Venous Access

Abstract

Background: Opioid use disorder poses an alarmingly significant public health risk. Persons who inject drugs (PWID) suffer from high mortality and morbidity secondary to serious infectious diseases, many of which require prolonged courses of parenteral antibiotics in the outpatient setting. The goal of this study was to determine the outcomes of PWID discharged to home or to a skilled nursing (SNF) or rehabilitation facility with parenteral antibiotic treatment under an outpatient parenteral antimicrobial therapy (OPAT) program. Methods: This is a retrospective observational study. The study population was identified via hospital and OPAT databases. The study population included PWID with known injection drug use in the preceding two years discharged between 2010 and 2015 to home or to a SNF/rehabilitation facility for a planned course of at least two weeks of parenteral antibiotics under the OPAT program. Retrospective chart review was used to describe patient characteristics and outcomes. Results: 52 patients were identified as meeting inclusion criteria, of which 21 were discharged to home and 31 to SNF/rehabilitation. Of the patients discharged to home, 17 (81%) were able to complete their planned antibiotic courses without complication. 20 (64%) of patients discharged to a SNF/rehabilitation facility completed the antibiotic courses without complication. Six (11%) patients had line infections, six patients had injection drug use relapse, and twelve (23%) patients had readmissions. Conclusions: PWID discharged home did not have a significantly higher rate of complications than those discharged to a rehabilitation facility and may be a safe discharge option in carefully selected patients.