Infective Endocarditis in Intravenous Drug Users—a Modern Outlook

Abstract

Infective endocarditis (IE) is a significant risk and complication in patients with a history of intravenous (IV) drug use (DU), and treatments are becoming more invasive as infections become more serious. IV drug use is an extremely addictive behavior and challenging behavior to address, and patients are at high risk of relapse to IV drug use even after successful IE treatment. Addressing the underlying cause with behavioral modification is essential to prevent behavior and subsequent infection recurrence. Treatments depend on a multidisciplinary approach to address the physiologic and underlying psychological conditions that lead to this type of infection. We seek to provide an update for providers on recent research and published literature on the subject of this type of infection. It is important to address this type of infection with a sensitive and collaborative approach. There has been a recent increase in the incidence of infective endocarditis even as rheumatic heart disease has decreased, and this has been attributed in part to the rise of IVDU-associated IE. The epidemiology of infective endocarditis has changed in recent years, reflecting the social climate of IV drug use. This in turn alters standard treatments for this type of infection, requiring a more multidisciplinary approach to address the diverse needs of this clinical population.