Outpatient Parenteral Antimicrobial Therapy Plus Buprenorphine for Opioid Use Disorder and Severe Injection-related Infections

Abstract

In a pilot randomized trial in persons with opioid use disorder hospitalized with injection-related infections, an innovative care model combining outpatient parenteral antimicrobial therapy with buprenorphine treatment had similar clinical and drug use outcomes to usual care (inpatient intravenous antibiotic completion) and shortened hospital length of stay by 23.5 days.

Clinical trials registration: NCT03048643.

Keywords: antibiotics; buprenorphine; endocarditis; injection-drug use; opioid-related disorders.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Figures

Figure 1.

(A) Mean (plus standard deviation) hospital length of stay in each group (t(17) = 6.9, P < .001). (B) Proportion of urine samples negative for illicit opioids during outpatient buprenorphine/naloxone (BUP) treatment, generalized estimating equation (GEE) analysis of the between-group difference with missing considered positive (odds ratio [OR], 4.2; 95% confidence interval [CI], 1.03–17.34; P = .049. (C) Retention in outpatient BUP treatment after hospital discharge, GEE analysis of the between-group difference (OR, 3.4; 95% CI, 0.68–1 3.50; P = .088). Abbreviation: OPAT, outpatient parenteral antimicrobial therapy.