In Staphylococcus aureus bacteremia, injection drug use is associated with younger age, homelessness, hepatitis C, MRSA, higher rates of patient-directed discharge, lower antibiotic completion rates, longer lengths of stay, and double the rate of recurrence. There was no difference in adherence to standards of care between patients with and without intravenous drug use. For persons who inject drugs, antibiotic completion improved with medications for opioid use disorder prescribed at discharge.