2289. Bacterial Causes of Acute Bacterial Skin and Skin Structure Infections (ABSSSI) in Patients with Intravenous Drug Use (IVDU): Phase 3 REVIVE Studies

Abstract

Background. Opioid addiction in the United States has reached epidemic proportions threatening public health. This analysis evaluates the baseline characteristics and bacterial causes of ABSSSI in patients who were IVDU from two parallel Phase 3 trials comparing the treatment of iclaprim with vancomycin. Methods. A total of 621 patients who were IVDU from two parallel Phase 3, double‐blind, randomized (1:1), active‐controlled, multinational, multicenter trials (REVIVE‐1 and REVIVE‐2) were analyzed both separately and pooled. This post‐hoc analysis summarizes the baseline bacterial causes of ABSSSI identified among IVDU. Per protocol, ABSSSI (major abscesses, cellulitis, or wound infections) were defined as having either the presence of purulent or seropurulent drainage before or after surgical intervention of the wound or at least 3 of the following signs and symptoms: discharge, erythema (extending at least 2 cm beyond the wound edge in any direction), swelling and/or induration, heat and/or localized warmth, and/or pain and/or tenderness to palpation. IVDU was defined based on subjected‐reported medical history. At the baseline visit, ABSSSI were sampled for microbiological culture. Cultures were performed locally, and isolates were submitted to the central microbiology laboratory. Results. Among IVDU with ABSSSI, average age was 44 years, 67.6% were male, average lesion size was 322 cm2, 10.8% had abnormal renal function (CrCl ≤ 90 mL/ minute), and 3.9% had bacteremia. The bacterial causes of ABSSSI among IVDU are shown in the Table. Conclusion. IVDU, a growing population, are vulnerable to ABSSSI. S. aureus, including MRSA, and S. anginosus group were the most commonly identified bacterial causes of ABSSSI in patients who are IVDU. Therefore, antibiotic selection should cover these bacteria among IVDU who present with an ABSSSI. (Figure Presented).