Healthcare News & Insights

Opioid use may contribute to pneumonia, infections in hospitals

Besides the growing opioid crisis in the nation, there’s another reason why hospitals should avoid prescribing these powerful drugs to patients if possible. They could increase a patient’s chances of developing one deadly illness the feds are monitoring closely: pneumonia. 

According to an article in Medscape, the new research findings were discussed by the head researcher, Dr. Andrea Rubinstein, at the American Academy of Pain Medicine’s 2017 annual meeting.

Relationship between drugs, pneumonia

Dr. Rubinstein and other researchers looked at over 40,000 admissions of patients to hospitals in the Kaiser Permanente Health System during a four-year period. Patients ranged in age from 18 to 70 with a variety of health conditions.

Specifically, researchers reviewed patients’ medical records to find out whether patients were prescribed at least a 60-day supply of opioids in the 100 days before being admitted to the hospital, as well as whether they received any opioids in the first two days of their hospital stay.

Patients were categorized depending on whether they received no opioids; fentanyl, codeine or morphine; or other opioids such as hydrocodone, hydromorphone or oxycodone.

Researchers then looked at rates of hospital-acquired pneumonia, a condition on the hitlist for the Centers for Medicare & Medicaid Services (CMS), focusing on cases that developed anywhere from day three to day 10 of a patient’s hospital stay.

Compared to rates in the general population, cases of hospital-acquired pneumonia in these patients were relatively rare. But patients who did develop the condition were more likely to have taken fentanyl, codeine or morphine shortly before being admitted to the hospital.

Breathing issues

To rule out all possible causes for the increased risk of hospital-acquired pneumonia in these patients, researchers also examined whether they contracted the illness due to breathing issues caused by respiratory depression. Respiratory depression is a common condition experienced by those taking opioids, and it can lead to many issues, including death.

Researchers compared the rates of all patients who developed pneumonia in the hospital after taking opioids with those who were on a ventilator and developed the illness. The rationale here was that, because these patients were breathing with assistance, respiratory depression wouldn’t impact pneumonia rates.

Even taking this added factor into consideration, patients who took morphine, codeine or fentanyl were more likely to develop pneumonia in the hospital.

Other infections

Given their findings, researchers speculated that opioids may have a negative impact on patients’ immune systems, making them more subject to contract illnesses.

As further proof of this theory, they examined rates of C. diff in the same patient populations, comparing those who took morphine, fentanyl and codeine with other patients. Those who took these opioids in the 100 days before admission were almost four times more likely to develop C. diff than those with no long-term exposure to opioids.

While researchers haven’t yet discovered exactly what opioids do to the immune system to produce this response, it’s further reason for hospitals to explore other avenues to relieve patients’ pain. Not only can this boost patients’ immune systems, reducing the chance of developing pneumonia or other deadly infections, it can help them avoid a dangerous opioid addiction.

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