INTRODUCTION: Risk factors for Clostridium difficile infection (CDI) include use of broad-spectrum antibiotics, advanced age and lack of an appropriate immune response. Whether antiperistaltics such as opioid analgesics also increase the risk of CDI is uncertain. The purpose of this preliminary study was to determine whether opioid analgesics increase the risk of developing CDI in hospitalized patients receiving broad-spectrum antibiotics. METHODS: Hospitalized patients were assessed for incidence of CDI in relation to usage of opioid analgesics controlling for other known risk factors for CDI. RESULTS: During the study period, a total of 32,775 patients were identified of whom 192 had CDI. In univariate analysis, incidence of CDI increased significantly with moderate or high usage of opioids (P < 0.0001). One hundred of 21,396 (0.47%) patients who did not receive opioids developed CDI. Twenty-two of 6955 patients (0.32%) with mild usage of opioids developed CDI [odds ratio (OR): 0.68; 95% confidence interval (CI): 0.43-1.1; P = 0.10]. Thirty of 33,203 (0.93%) with moderate usage developed CDI (OR: 2.0; 95% CI: 1.3-3.0; P = 0.0009). Forty of 1029 (3.7%) patients with high usage of opioids developed CDI (OR: 8.3; 95% CI: 5.7-12.1; P < 0.0001). Similar results were observed using a multivariate Cox proportional hazard model. CONCLUSIONS: Moderate to high use of opioid analgesics were associated with an increased risk of CDI.
INTRODUCTION: Risk factors for Clostridium difficileinfection (CDI) include use of broad-spectrum antibiotics, advanced age and lack of an appropriate immune response. Whether antiperistaltics such as opioid analgesics also increase the risk of CDI is uncertain. The purpose of this preliminary study was to determine whether opioid analgesics increase the risk of developing CDI in hospitalized patients receiving broad-spectrum antibiotics. METHODS: Hospitalized patients were assessed for incidence of CDI in relation to usage of opioid analgesics controlling for other known risk factors for CDI. RESULTS: During the study period, a total of 32,775 patients were identified of whom 192 had CDI. In univariate analysis, incidence of CDI increased significantly with moderate or high usage of opioids (P < 0.0001). One hundred of 21,396 (0.47%) patients who did not receive opioids developed CDI. Twenty-two of 6955 patients (0.32%) with mild usage of opioids developed CDI [odds ratio (OR): 0.68; 95% confidence interval (CI): 0.43-1.1; P = 0.10]. Thirty of 33,203 (0.93%) with moderate usage developed CDI (OR: 2.0; 95% CI: 1.3-3.0; P = 0.0009). Forty of 1029 (3.7%) patients with high usage of opioids developed CDI (OR: 8.3; 95% CI: 5.7-12.1; P < 0.0001). Similar results were observed using a multivariate Cox proportional hazard model. CONCLUSIONS: Moderate to high use of opioid analgesics were associated with an increased risk of CDI.
Authors: E Jennifer Edelman; Kirsha S Gordon; Kristina Crothers; Kathleen Akgün; Kendall J Bryant; William C Becker; Julie R Gaither; Cynthia L Gibert; Adam J Gordon; Brandon D L Marshall; Maria C Rodriguez-Barradas; Jeffrey H Samet; Amy C Justice; Janet P Tate; David A Fiellin Journal: JAMA Intern Med Date: 2019-03-01 Impact factor: 21.873
Authors: Monica Chowdhry; Douglas Haden; Suzanne Kemper; Kristen Helmick; Muhammad Kawsara; Ashley Huggett; Andrea Stark; Ahmad Khan; Muhammad Shah; Mustafa Bhaty; Junaid Farooq; Shailendra Singh; Brittain McJunkin Journal: Pain Manag Date: 2020-12-22
Authors: Rodrigo Duarte-Chavez; Thomas R Wojda; Thomas B Zanders; Berhanu Geme; Gloria Fioravanti; Stanislaw P Stawicki Journal: J Glob Infect Dis Date: 2018 Apr-Jun