Anchoring Sequential Intermittent Long Acting Antimicrobials With Medication for Opioid Use Disorder (MOUD) for Invasive Infections Related to Opioid Use

Who can take part

• Age 18 years old
• Able and willing to sign consent
• Ongoing opioid use defined by self report of use of non prescription opioids within 3 months of hospitalization
• Has infection determined to be from opioid/drug use and needed prolonged parenteral antimicrobial therapy
• Gram positive organism as causal pathogen and expected to be sensitive to oritavancin
• Deemed to be clinically stable for discharge (i.e no need for surgical intervention, with stable vital signs,afebrile and bacteremia cleared if present at admission for at least 72 hours)
• Not on opioid agonist therapy at admission to hospital and willing to initiate medication for opioid use disorder, which includes methadone/suboxone
• Willing and able to follow up for MOUD in colocated clinic site
• If female, the patient is surgically sterile, postmenopausal, or, if of childbearing potential, agrees to use at least 2 highly effective methods of birth control (e.g. prescription oral contraceptives, contraceptive injections, contraceptive patch, intrauterine device, barrier methods, abstinence) for the duration of the study until 60 days after study drug administration, or male partner sterilization alone

Who cannot take part

• Require valve replacement surgery or have prosthetic material in body including prosthetic joints or non bioprosthetic valves
• On prohibited concomitant medications
• Known immediate hypersensitivity to oritavancin or glycopeptides
• Have any condition that the investigator considers a contraindication to study participation
• Polymicrobial infection
• Multisite infection- defined as >2 different organ system involvement or non-contiguous sites of same organ system which may need different duration of antimicrobial therapy
• Lack of source control i.e lack of drainage of infected fluid collections, debridement of infected solid or necrotic tissue, removal of devices or foreign bodies, or definitive measures to correct anatomic derangements resulting in ongoing microbial contamination. This will be determined by investigator
• Acute stroke during hospitalization
• Decompensated liver disease (Childs Pugh B or C) or Stage IV/V chronic kidney disease or acute kidney injury with creatinine clearance <30
• Poor venous access not allowing screening laboratory collection
• Severe neutropenia- ANC <500 or thrombocytopenia - platelet count <50,000
• Unable to comply with research study visits
• Pregnant or breastfeeding woman
• Need for subacute rehabilitation due to physical frailty either chronic, or from hospitalization