{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T18:31:50Z","timestamp":1791570710357,"version":"4.3.4"},"reference-count":92,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>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)\u2013 and group A Streptococcus (GAS)\u2013infected wounds, specifically oral trimethoprim-sulfamethoxazole for MRSA and oral \u03b2-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.<\/jats:p>","DOI":"10.1093\/ofid\/ofaf299","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T19:05:01Z","timestamp":1747335901000},"source":"Crossref","is-referenced-by-count":13,"title":["Multidisciplinary Guidance to Care for Persons With Xylazine-Associated Wounds"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3605-8724","authenticated-orcid":false,"given":"Wei-Teng","family":"Yang","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania ,","place":["USA"]},{"name":"Center for Addiction Medicine and Policy, University of Pennsylvania , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica A","family":"Meisner","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania ,","place":["USA"]},{"name":"Prevention Point Philadelphia , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5590-2736","authenticated-orcid":false,"given":"Christina","family":"Maguire","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Penn Presbyterian Medical Center , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly E","family":"Dyer","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"McFadden","sequence":"additional","affiliation":[{"name":"Prevention Point Philadelphia , Philadelphia, Pennsylvania ,","place":["USA"]},{"name":"Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish P","family":"Thakrar","sequence":"additional","affiliation":[{"name":"Center for Addiction Medicine and Policy, University of Pennsylvania , Philadelphia, Pennsylvania ,","place":["USA"]},{"name":"Division of General Internal Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8018-4070","authenticated-orcid":false,"given":"Drew T","family":"Dickinson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Hospital of the University of Pennsylvania , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanna","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Penn Presbyterian Medical Center , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ave","family":"Preston","sequence":"additional","affiliation":[{"name":"Department of Wound and Ostomy Nursing, Hospital of the University of Pennsylvania , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1926-7800","authenticated-orcid":false,"given":"Michael Z","family":"David","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanmarie","family":"Perrone","sequence":"additional","affiliation":[{"name":"Center for Addiction Medicine and Policy, University of Pennsylvania , Philadelphia, Pennsylvania ,","place":["USA"]},{"name":"Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naasha","family":"Talati","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen O","family":"Degnan","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of Pennsylvania Perelman School of Medicine , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"2025062505201713600_ofaf299-B1","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1056\/NEJMp2303120","article-title":"Xylazine\u2014medical and public health imperatives","volume":"388","author":"Gupta","year":"2023","journal-title":"N Engl J Med"},{"key":"2025062505201713600_ofaf299-B2","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1097\/ADM.0000000000001132","article-title":"Widespread distribution of xylazine detected throughout the United States in healthcare patient samples","volume":"17","author":"Holt","year":"2023","journal-title":"J Addict Med"},{"key":"2025062505201713600_ofaf299-B3","doi-asserted-by":"crossref","first-page":"109380","DOI":"10.1016\/j.drugalcdep.2022.109380","article-title":"Xylazine spreads across the US: a growing component of the increasingly synthetic and 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