New research by the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney and UCL has found use of opioid agonist treatment (OAT) following hospitalisation with injection drug use-associated bacterial and fungal infections is associated with lower risk of death and recurrent infections.  

NDARC researchers identified 8,943 people with opioid use disorder who were admitted to hospitals in New South Wales between 2001 and 2018 with injecting-related infections.

This included skin and soft-tissue infection, sepsis/bacteraemia, endocarditis, osteomyelitis, septic arthritis, and epidural/brain abscess.

Lead author of the study, NDARC Visiting Fellow, Dr Thomas Brothers said the treatment of injecting-related infections tend to focus on antimicrobial therapy and/or surgery, without adressing underlying substance use-related needs.

"Injecting-related bacterial and funagl infections are associated with significant morbidity and mortality among people who inject drugs," Dr Brothers said.

"We found that use of OAT after hospital discharge was associated with lower risks of death and rehospitalisation with injecting-related infections.

"Patients and their families, clinicians and halth providers should be aware of the potential role and benefit of OAT in this setting."

OAT (including methadone and buprenorphine) has also been associated with decreased risks of other injecting-related health harms, including HIV infection, hepatitis C virus infection, and overdose death.

NDARC Director and co-author, Professor Michael Farrell said OAT should be considered as part of a multi-component treatment strategy for injecting-related infections.

"Clinicians, hospitals and health systems should facilitate access to OAT for these patients," Professor Farrell said.

Opioid agonist treatment and risk of death or rehospitalisation following injection drug use-associated bacterial and fungal infections: a cohort study in New South Wales, Australia is available in PLOS Medicine.

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