It's standard protocol to let patients with infections finish IV antibiotic treatment at home — unless they have a history of drug use. Now, some doctors are challenging that. “People who use drugs deserve the same standard of care,” one doctor says.
Partners visiting nurse Brenda Mastricola tends to Arthur Jackson’s foot during a visit at his home in Roxbury. His large toe has been amputated due to an infection.
“This all looks good,” Mastricola tells Jackson as she checks to make sure the line is clean and in place. “You don’t need me.” “Every time someone uses injection drugs they’re putting themselves at risk for a very complicated infection,” Price says.out of North Carolina found a 12-fold increase in endocarditis, a heart infection, within one decade. But treatment options for patients with a history of drug use are limited. Some skilled nursing facilities, home care agencies and antibiotic infusion companies won’t work with these patients once they’re released from a hospital.
Price and colleagues began months of discussions with heart, bone and joint specialists, surgeons and nurses who would need to buy-in, so their patients could participate. In the spring of 2018, Price and Solomon and others enrolled a few patients, then a few more, admittedly cherry-picking those who wanted to be in treatment and who had a sober, stable home.Arthur Jackson says there shouldn’t have been any question that he met the first and second requirements. He’d been on methadone for 10 years, used heroin again, then switched to Suboxone, a version of buprenorphine that he’s been taking for two years.
“Everyone makes such a big deal about this PICC line,” says Stephen Connolly, 36, who went home with the open port last year to treat endocarditis. “If I want to get high, I know how to do it. I’m not going to mess around with a PICC.”
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