Starrels et al identified reasons why an intravenous drug user may take antibiotics inappropriately. This may contribute to poor outcomes. The authors are from the University of Pennsylvania, Veterans Affairs Medical Center and Albert Einstein College of Medicine.
Patient selection: intravenous drug abuser with an infection requiring antibiotic therapy
Common behaviors of intravenous drug users include:
(1) delay in seeking medical care
(2) failure to fill prescriptions for antibiotics
(3) obtaining antibiotics from non-provider sources
(4) inappropriate antibiotic use
Inappropriate antibiotic use includes:
(1) use of an antibiotic to treat a condition not responsive to the antibiotic
(2) use of an overly broad-spectrum antibiotics
(3) incorrect antibiotic therapy duration
(4) poor drug adherence
Predictors of inappropriate antibiotic use:
(1) failure to recognize the severity of the infection
(2) reluctance to wait to be seen
(3) previous mistreatment by providers
(4) lack of health insurance
(5) purchase of drugs prioritized over antibiotics
(6) forgetting to take antibiotics
(7) fear of interaction between antibiotics and abused substances or other adverse effects
(8) irregular diet
(9) failure to understand the concept of antibiotic resistance
