Oral Antibiotics for Complicated Staph Infection in People Who Inject Drugs

The dogma that antibiotics for complicated Staphylococcus aureus infections must always be administered intravenously has been challenged by recent studies demonstrating good outcomes with partly oral treatment (NEJM Infect Dis Oct 2018 and N Engl J Med 2019; 380:415). How well this strategy works in ordinary practice, though, isn't clear, particularly when injection drug use complicates the picture. Researchers reviewed the records of 238 people who inject drugs and were admitted to a single hospital for S. aureus bacteremia with endocarditis, osteomyelitis, septic arthritis, or epidural abscess. Half of them received the standard 6-week course of intravenous antibiotics. The others received part-intravenous, part-oral treatment, or just a…