Multidisciplinary Guidance to Care for Persons With Xylazine-Associated Wounds

作者：Wei-Teng Yang, Jessica Meisner, Christina Maguire, Kelly E Dyer, Rachel McFadden, Ashish P. Thakrar, Drew T. Dickinson, Deanna Berg, Ave Maria Preston, Michael David, Jeanmarie Perrone, Naasha J Talati, Kathleen Degnan · 发表于：Open Forum Infectious Diseases · 年份：2025 · DOI：10.1093/ofid/ofaf299 · 被引用次数：9 · 研究领域：Veterinary Pharmacology and Anesthesia、Antimicrobial Resistance in Staphylococcus、Forensic Toxicology and Drug Analysis

Abstract Xylazine, an adulterant of unregulated opioid supplies, is increasingly prevalent in the United States and associated with distinctive wounds. Xylazine-associated wounds (XAWs) are primarily noted in the extremities and are not always associated with injection drug use. XAWs are often chronic and can become superinfected, posing a great challenge to clinical care. We share multidisciplinary guidance to care for persons with XAWs: (1) substance use disorder treatment and longitudinal multidisciplinary care including addiction medicine, wound care, infectious diseases, and surgery are imperative; (2) avoid aggressive debridement; (3) administer empirical antibiotics for methicillin-resistant Staphylococcus aureus (MRSA)– and group A Streptococcus (GAS)–infected wounds, specifically oral trimethoprim-sulfamethoxazole for MRSA and oral β-lactams for GAS; (4) administer intravenous daptomycin to reduce the discomfort and challenges associated with frequent phlebotomy for vancomycin therapeutic drug monitoring; and (5) create explicit contingency antibiotic plans with potential use of linezolid, tedizolid, or dalbavancin for patient-directed hospital discharge.