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Incidence and treatment costs of severe bacterial infections among people who inject heroin: A cohort study in South London, England.

Lewer, D, Hope, VD, Harris, M, Kelleher, M, Jewell, A, Pritchard, M, Strang, J and Morley, KI (2020) Incidence and treatment costs of severe bacterial infections among people who inject heroin: A cohort study in South London, England. Drug and Alcohol Dependence, 212. ISSN 0376-8716

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Abstract

BACKGROUND: People who inject drugs often get bacterial infections. Few longitudinal studies have reported the incidence and treatment costs of these infections. METHODS: For a cohort of 2335 people who inject heroin entering treatment for drug dependence between 2006 and 2017 in London, England, we reported the rates of hospitalisation or death with primary causes of cutaneous abscess, cellulitis, phlebitis, septicaemia, osteomyelitis, septic arthritis, endocarditis, or necrotising fasciitis. We compared these rates to the general population. We also used NHS reference costs to calculate the cost of admissions. RESULTS: During a median of 8.0 years of follow-up, 24 % of patients (570/2335) had a severe bacterial infection, most commonly presenting with cutaneous abscesses or cellulitis. Bacterial infections accounted for 13 % of all hospital admissions. The rate was 73 per 1000 person-years (95 % CI 69-77); 50 times the general population, and the rate remained high throughout follow-up. The rate of severe bacterial infections for women was 1.50 (95 % CI 1.32-1.69) times the rate for men. The mean cost per admission was £4980, and we estimate that the annual cost of hospital treatment for people who inject heroin in London is £4.5 million. CONCLUSIONS: People who inject heroin have extreme and long-term risk of severe bacterial infections.

Item Type: Article
Uncontrolled Keywords: 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0440 Study and Teaching. Research
Divisions: Public Health Institute
Publisher: Elsevier
Related URLs:
Date Deposited: 26 May 2020 08:53
Last Modified: 26 May 2020 09:00
DOI or Identification number: 10.1016/j.drugalcdep.2020.108057
URI: http://researchonline.ljmu.ac.uk/id/eprint/12995

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