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The Impact of MOUD Initiation in Patients With Injection Drug Use-Associated Infective Endocarditis

Seth Losiewicz1, Bennett Collis2, Sami El-Dalati3

  • 1Department of Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky, USA.

Open Forum Infectious Diseases
|May 25, 2026
PubMed

Insights

Medications for opioid use disorder (MOUD) significantly reduced 30-day mortality in patients with infective endocarditis linked to injection drug use. MOUD showed a nonsignificant trend toward increased antibiotic treatment completion.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Addiction Medicine

Background:

  • Infective endocarditis is a serious complication in patients with injection drug use.
  • Opioid use disorder (OUD) presents significant challenges in managing infective endocarditis.
  • Medications for opioid use disorder (MOUD) are crucial for comprehensive patient care.

Purpose of the Study:

  • To evaluate the impact of MOUD initiation on treatment outcomes for patients with injection drug use-associated infective endocarditis.
  • To assess the association between MOUD and antibiotic treatment completion and mortality rates.

Main Methods:

  • Retrospective, single-center study design.
  • Evaluation of 218 patients with injection drug use-associated infective endocarditis.
  • Comparison of outcomes between patients receiving MOUD and those who did not.

Main Results:

  • Initiation of MOUD was associated with a significant reduction in 30-day postdischarge mortality.
  • A nonsignificant increase in antibiotic treatment completion was observed with MOUD initiation.
  • MOUD did not show a significant impact on 90-day mortality.

Conclusions:

  • MOUD initiation is associated with improved short-term survival in patients with injection drug use-associated infective endocarditis.
  • Further research is needed to explore the long-term effects of MOUD on mortality and treatment adherence.
  • Integrating MOUD into the care of patients with infective endocarditis may improve patient outcomes.
Keywords:
endocarditisinjection drug usemedications for opioid use disordermultidisciplinary teams

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