Infectious Disease

What other ID dogma should be reevaluated?

September 29, 2023

1 min read

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Disclosures:
Barocas reports no relevant financial disclosures.

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As experts raise awareness of the evidence supporting shorter antibiotic therapy for some conditions and the benefits of oral vs. IV-only therapy for others, we wanted to know: What is another ID dogma that should be reevaluated?

We asked Joshua Barocas, MD, associate professor of medicine at the University of Colorado School of Medicine and chair of the Infectious Diseases Society of America’s Public Health Committee.

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Barocas: One pervasive dogma throughout ID and all of medicine is that people who use drugs cannot be “trusted” to be adherent to medication recommendations.

Beginning with studies in the 1990s that demonstrated that people experiencing homelessness — with a history of injection drug use — could achieve virologic suppression, a number of subsequent studies have debunked the myth that “drug users can’t be trusted.” Time and again, studies have demonstrated their adherence to medication regimens such as direct-acting antivirals for hepatitis C, IV and oral antibiotics for serious bacterial infections and therapy for tuberculosis.

Is it true that some people need additional supports to overcome competing factors like lack of food, transportation and housing? Yes. But the idea that people who use drugs are a special population who do not “comply” with recommendations is patently false.

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