Photo Credit CDC
Note: I’ll be on the road today and tomorrow, and may not be able to update this blog until Sunday.
In the meantime, I invite you to check in with Crofsblog for the latest news, Maryn McKenna for the latest on antibiotic resistance (and other topics), and to explore FluTrackers.
# 6768
A study that appeared this week in the BMJ respiratory disease journal Thorax finds that `Benzodiazepines were associated with an increased risk of, and mortality from CAP’ (Community Acquired Pneumonia).
Benzodiazepines are a commonly prescribed class of anti-anxiety, sedative, and anti-convulsive medications that include such stalwarts as Valium, Paxal, and Halcion (among many others).
Their sedative effects can (particularly when combined with alcohol) depress the respiratory system, and act as a cough suppressant – both of which could conceivably contribute to an increased incidence of pneumonia.
The study – which looked at nearly 5,000 pneumonia cases and more than 29,500 controls - found a 54% increase in pneumonia among patients taking benzodiazepines (although not with chlordiazepoxide (Librium)) and a 22% increased mortality rate.
A link to the study, and excerpts from the abstract follow:
The impact of benzodiazepines on occurrence of pneumonia and mortality from pneumonia: a nested case-control and survival analysis in a population-based cohort
Eneanya Obiora, Richard Hubbard, Robert D Sanders, Puja R Myles
Abstract
Objectives Benzodiazepines have been associated with an increased incidence of infections, and mortality from sepsis, in the critically ill. Here, we determined the effect of community use of benzodiazepines on the occurrence of, and mortality following, pneumonia.
<SNIP Methods & Results>
Conclusions Benzodiazepines were associated with an increased risk of, and mortality from, CAP. These hypothesis generating data suggest further research is required into the immune safety profile of benzodiazepines.
It is worth noting that an earlier study (J Am Geriatr Soc. 2011 Oct) found quite the opposite; that opioids, but not benzodiazepines, were associated with increased incidences of pneumonia.
Use of opioids or benzodiazepines and risk of pneumonia in older adults: a population-based case-control study.
Dublin S, Walker RL, Jackson ML, Nelson JC, Weiss NS, Von Korff M, Jackson LA.
Source
Group Health Research Institute, Seattle, Washington 98101, USA. dublin.s@ghc.org
Abstract
OBJECTIVES:
To examine whether use of opioids or benzodiazepines is associated with risk of community-acquired pneumonia in older adults.
CONCLUSION:
Use of opioids but not benzodiazepines was associated with pneumonia risk. The differences in risk seen for different opioid regimens warrant further study.
Dueling studies are nothing new. Different methodologies, and different patient demographics, can produce strikingly different results.
The second study - which found no link between benzodiazepines and pneumonia - looked only at older patients (aged 65 to 94), and was based on a much smaller number of pneumonia cases and controls.
So while similar in intent, comparing these studies is not quite like comparing apples to apples.
Although not a slam dunk, there is enough evidence here that the authors of this week’s study urge:
These hypothesis generating data suggest further research is required into the immune safety profile of benzodiazepines.
