Web ExclusivesMarch 2023Annals for Hospitalists Inpatient Notes - Clinical Pearls—Outpatient Parenteral Antimicrobial Therapy for Infective Endocarditis in Persons Who Inject DrugsLarry M. Baddour, MD and Daniel C. DeSimone, MDLarry M. Baddour, MDDivision of Public Health, Infectious Diseases and Occupational Health, Departments of Medicine and Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic Rochester, Rochester, Minnesota (L.M.B., D.C.D.).Search for more papers by this author and Daniel C. DeSimone, MDDivision of Public Health, Infectious Diseases and Occupational Health, Departments of Medicine and Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic Rochester, Rochester, Minnesota (L.M.B., D.C.D.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-0241 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A 26-year-old woman presented to the emergency department for fever and chills of 5 days duration. Her recent history included injection drug use of both heroin and cocaine, and she had shared paraphernalia on 2 occasions over a weekend party. She was ultimately diagnosed with bilateral (tricuspid and aortic) infective endocarditis (IE) due to methicillin-susceptible Staphylococcus aureus. After an 8-day hospital stay, she was transitioned to outpatient parenteral antimicrobial therapy (OPAT) and buprenorphine (which had been initiated on day 2 of the hospital stay), with outpatient follow-up by addiction medicine and infectious diseases. A peripherally inserted central catheter (PICC) was ...