Outpatient Antibiotic Fills and 30-Day Readmission Following Patient-Directed Discharge in Drug Use-Associated Infective Endocarditis in a National Medicaid Cohort

Clicks: 24
ID: 332398
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #257 of 635 articles by views in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 635 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Antibiotic strategies for drug use-associated infective endocarditis (DUA-IE) are evolving, but data are limited regarding antibiotic access after patient-directed discharge (PDD). We examined antibiotic fill patterns and 30-day readmission among DUA-IE patients with and without PDD. Methods Using national Medicaid data (2016–2022), we identified adults aged 18–64 with new DUA-IE episodes. We measured antibiotic fill rates among patients discharged to non-facility settings. We used a landmark design, requiring readmission-free survival for 3 days after discharge to observe antibiotic fills. We used multivariable logistic regression to assess associations between PDD and antibiotic fill with 30-day readmission, overall and stratified by PDD status. Results Among 19,808 patients included, 5,519 (27.9%) left via PDD. Compared with non-PDD patients, PDD patients were younger, had fewer comorbidities, and had more polysubstance use. Only 17.1% of PDD patients had an antibiotic fill within 3 days versus 44.2% of non-PDD patients (adjusted odds ratio [aOR] 0.25; 95% CI, 0.20–0.33). PDD was associated with increased readmission (aOR 1.91; 95%CI, 1.65–2.21), while antibiotic fill was associated with reduced readmission (aOR 0.45; 95%CI, 0.40–0.50). In stratified analyses, antibiotic fill was associated with a larger magnitude of readmission reduction among PDD patients (aOR 0.27; 95%CI, 0.21–0.34) than among non-PDD patients (aOR 0.50; 95%CI, 0.46–0.55; p for interaction <.001). Conclusions These findings highlight the need for proactive strategies that ensure treatment continuity including planning for potential PDD, bedside medication delivery, and expanded use of oral and long-acting intravenous antibiotics.
Reference Key
openalex_W7221792719 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Fiona E. Gispen, Jialin Mao, Kenneth Karan, Yuhua Bao, Ximena A. Levander, Elaine Wethington, Benjamin J. Eckhardt, Brianna Sustersic, Shashi N. Kapadia
Are you one of these authors? Claim your profile
Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Year 2026
DOI
10.1093/cid/ciag649
URL
https://doi.org/10.1093/cid/ciag649
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.