Patients' Perspectives on Alternative Antibiotic Treatment Strategies for Infective Endocarditis Among Persons Who...

Area of Science:

• Infectious Diseases
• Public Health
• Health Services Research

Background:

• Injection drug use is a significant and increasing risk factor for infective endocarditis (IE).
• Current standard treatment for drug use-associated IE (DUA-IE) involves lengthy inpatient antimicrobial therapy.
• Alternative antibiotic delivery methods are being explored but patient acceptance is unknown.

Purpose of the Study:

• To explore patient preferences and identify barriers/facilitators for different DUA-IE treatment strategies.
• To understand the perspectives of individuals with DUA-IE on proposed treatment options.

Main Methods:

• Semi-structured interviews were conducted with 16 individuals hospitalized with DUA-IE.
• Participants discussed three treatment options: standard inpatient care, home-based outpatient parenteral antimicrobial therapy, and weekly outpatient infusions.
• Interviews were thematically coded to analyze participant perspectives.

Main Results:

• The standard inpatient treatment (Option A) was the most preferred regimen (50%).
• Weekly outpatient infusions (Option C) were preferred by 31%, and home-based therapy (Option B) by 19%.
• While outpatient options offered convenience, transportation and housing instability were major barriers.

Conclusions:

• Patient perspectives are crucial for designing future DUA-IE treatment trials.
• Interventions addressing patient-centered needs and barriers are necessary for effective DUA-IE management.
• Understanding patient preferences can inform the development of acceptable and effective alternative treatment strategies.