S2 Ep3: #14 Getting to the Heart of Injection Drug Use Associated Infectious Endocarditis with Dr. Ayesha Appa
Jul 20, 2023
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Dr. Ayesha Appa discusses person-centered care when treating infectious endocarditis in injection drug users. The importance of multidisciplinary teams, treatment strategies, and patient-centered history. The challenges of counseling patients on safer injection practices and treatment options for opioid use disorder and infectious endocarditis are also explored.
A patient-centered approach to managing substance use involves addressing immediate needs and preferences, not just gathering information.
Collaboration between addiction medicine and infectious diseases specialists improves outcomes for patients with substance use disorders and infectious endocarditis.
Choosing the right antibiotic regimen for endocarditis involves considering factors such as route of administration, feasibility, and patient preferences.
Deep dives
Taking a patient-centered approach to substance use history
When gathering substance use history, it's important to focus on management and address immediate needs, rather than just gathering information. A patient-centered approach involves iteratively assessing the type and route of substance use, as well as treatment history and preferences.
Collaborating with multi-disciplinary teams
Working with multi-disciplinary endocarditis teams can improve patient outcomes and decrease in-hospital mortality. Collaboration between addiction medicine and infectious diseases specialists is crucial in providing comprehensive care for patients with substance use disorders.
Individualizing treatment options
Considering the patient's priorities and feasibility, the right antibiotic regimen can be chosen for the treatment of endocarditis. This involves assessing factors such as route of administration, PK and dosing schedule, and clinical experience. The goal is to find an antibiotic regimen that is effective, feasible, and aligned with the patient's preferences.
Utilizing alternatives to traditional IV treatment
Exploring options such as Delafloxacin or oral antibiotics can provide effective treatment for endocarditis, especially when IV therapy is not feasible or preferred. These alternative options should be discussed with the patient to find the best solution based on their individual circumstances.
Addressing the stigma around substance use
It is important to challenge the discrimination and stigma that patients who use drugs may face when seeking medical care. Encouraging a non-judgmental and supportive environment can help foster trust and improve outcomes for these patients.
Bring some heart to the care of people with IDU-IE. Learn how to provide person-centered care addressing both the acute infection and SUD and when/how to advocate for surgical treatment. We’re joined by Dr. Ayesha Appa @AyeshaAppaMD, (UCSF)