Surgical treatment of infective endocarditis in intravenous drug abusers Full Text

In most cases, these organisms are streptococci (“strep”), staphylococci (“staph”) or species of bacteria that normally live on body surfaces. The standard treatment for infective endocarditis – six weeks of intravenous antibiotics – is not always possible for people who inject drugs because they often leave the hospital before treatment is completed. Research suggests other options, such as shorter intravenous antibiotic regimens followed by oral antibiotics, or just oral antibiotics, might help these patients complete treatment. The writing group also stresses that people with infective endocarditis who inject drugs should be considered for heart valve repair or replacement surgery regardless of current drug use if they have indications for valve surgery. The multidisciplinary care team should include cardiologists, cardiac surgeons and infectious diseases specialists, as well as addiction medicine or addiction psychiatry specialists, pharmacists, social workers and nurse specialists. The nurse specialists may provide coordinated care from the initial hospitalization for infective endocarditis to outpatient and community care to support substance use disorder.

• The microorganisms initially attach to the platelet-fibrin nidus and then proliferate .
• All procedures were performed on cardiopulmonary bypass with mild hypothermia.
• Peripheral embolization must alert one to the presence of concomitant left-sided endocarditis or a shunt.
• The study tracked rates of infective endocarditis, which occurs when harmful bacteria build up on the heart’s valves or the inside lining of the heart.
• The data for each patient were confirmed with reference to the written medical record as well as local electronic data systems.

There is no significant difference in survival between those receiving mechanical or bioprosthetic valve replacement. The primary outcomes were all-cause mortality at 30 days following completion of antimicrobial therapy, 30 days following surgery, and at 1, 3, 5, and 10 years. Patients were followed up until death or 1 year following study completion. Secondary outcomes were IE-related mortality, relapse, recurrence, and a second operation.

Study limitations

The medicine can rapidly reverse an opioid overdose and is often available at local pharmacies without a prescription. STAT’s coverage of chronic health issues is supported by a grant fromBloomberg Philanthropies. Our financial supportersare not involved in any decisions about our journalism. While some experts welcome the new guidance, they concede that in some cases it’s impossible to live up to. Good dental hygiene is an important part of maintaining your overall health. Bacteria can attach to an implanted device, such as a pacemaker, causing an infection of the heart’s lining.

In this article, basic iv drug use, clinical, and microbiological data on this topic are presented. It is apparent that no clear unifying mechanism emerges to explain the well-documented clinical predilection for the infection of the right-side heart valves in this population. Further investigation of this topic utilizing large international clinical registries may help to clarify matters further.

Clinical Topics

She has also started serving as an advocate of sorts for others in her community who get endocarditis or other infections from injecting, driving them to the emergency room or sharing every detail of the protocol that saved her. She smarts at the thought of providing only “comfort care” — antibiotics but no surgery — even if a patient refuses addiction treatment. He set up a task force in 2016 to address the problem but has faced obstacles, especially concerning cost and, he believes, a societal reluctance to spend money on people who abuse drugs.