ORN Summer 2024 - BUGS AND DRUGS: Case-Based Pearls for Addiction Consultants Treating People Who Use Drugs Hospitalized with Infections-Recording - ORN Summer 2024 -Drugs and Bugs

Video Transcription

Video Summary

The transcript covers a detailed webinar on managing infections in people who use drugs, focusing on case studies and shared decision-making. The speaker, Dr. Aisha Appa, is an Assistant Professor of Medicine at UCSF, specializing in HIV and infectious diseases. She emphasizes the integration of HIV care with substance use disorder treatment.<br /><br />Dr. Appa discusses four cases to highlight treatment complexities and approaches:<br />1. <strong>Case 1</strong>: A 35-year-old woman with opioid use disorder on methadone, hospitalized with a dental infection, and treated with IV antibiotics. Dr. Appa suggests outpatient parenteral antibiotic therapy (OPAT) might be possible if the patient’s needs and safety are considered.<br />  <br />2. <strong>Case 2</strong>: A 44-year-old man with MRSA endocarditis on vancomycin and having opioid use disorder, managed with methadone. The risk of rifampin-induced withdrawal is discussed, and alternatives like long-acting injectable antibiotics are explored.<br />   <br />3. <strong>Case 3</strong>: A 26-year-old woman with stimulant use disorder and bacteremia. Emphasis is on secondary infection prevention, providing harm reduction supplies, and considering PrEP for HIV prevention.<br />  <br />4. <strong>Case 4</strong>: A 52-year-old man with opioid and stimulant use disorders caught with paraphernalia while on IV antibiotics. Shared decision-making is crucial for continuing his treatment safely, considering his needs and preferences.<br /><br />Throughout the cases, Dr. Appa highlights the importance of understanding patient needs, harm reduction, and shared decision-making to ensure better health outcomes. Tools for assessing risk, multi-disciplinary case conferences, and specific antibiotic strategies are discussed. The webinar concludes with a Q&A session addressing practical issues and treatment approaches for this complex patient population.

Keywords

infections

substance use disorder

HIV care

Dr. Aisha Appa

case studies

shared decision-making

harm reduction

OPAT

antibiotic therapy

multi-disciplinary