Long-term outcomes of intravenous drug use associated infective endocarditis: a contemporary 20-year study

Abstract Introduction Intravenous drug use (IVDU) associated infective endocarditis (IE) is a clinically challenging case. Not only can the natural history of IE in IVDU population be significantly different, making detection diagnostic dilemma, additional social factors with this drastically change management, including suitability for surgery or long-term intravenous access antibiotics Furthermore, rates are increasing globally, leading to incidence IE. Purpose With lack clear mangement guidelines IE, our study assesses differences presentation, management and prognosis between non-IVDU help guide future care. Methods This an observational cohort on prospectively collected database 350 patients treated at centre 1999 2015. Patients were followed-up until death January 2021. The primary outcome was all-cause mortality. Continuous variables compared using unpaired t-test. Categorical Chi-square test when sample size >5 Fisher's exact ≤5. Long-term survival data analysed Kaplan-Meier curves. Results younger, more likely have concurrent infections other substance use, while older higher level overall comorbidity. become reinfected (p-value=0.034) but had better (p<0.001). Survival estimates 15-years 64.98% (95% CI: 50.94–75.92%) 26.67% 19.76–34.05%) (p-value<0.0001). Conclusion Despite having levels reinfection, outcomes patients. Therefore, should not blanket restrictions they offered unless individual has contraindications particular therapy. FUNDunding Acknowledgement Type funding sources: None.