Non-steroidal Anti-inflammatory Drugs may Worsen the Course of Community-Acquired Pneumonia: A Cohort Study

Purpose Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed or used as self-medication in cases of community-acquired pneumonia (CAP). Nevertheless, the consequences of such medication on the risk of pleuroparenchymal complications are not well known. The aim was to investigate...

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Published in:Lung Vol. 195; no. 2; pp. 201 - 208
Main Authors: Basille, Damien, Plouvier, Nathalie, Trouve, Charlotte, Duhaut, Pierre, Andrejak, Claire, Jounieaux, Vincent
Format: Journal Article
Language:English
Published: New York Springer US 01.04.2017
Springer
Springer Nature B.V
Springer Verlag
Subjects:
Adult
Aged
Aged, 80 and over
Alcoholism - complications
Anti-Bacterial Agents - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Community-Acquired Infections - complications
Community-Acquired Infections - drug therapy
Female
Human health and pathology
Humans
Intensive Care Units
Length of Stay
Life Sciences
Lung Abscess - etiology
Male
Medicine
Medicine & Public Health
Middle Aged
Nonsteroidal anti-inflammatory drugs
Patient Admission
Pleural Effusion - etiology
Pneumology/Respiratory System
Pneumonia
Pneumonia - complications
Pneumonia - drug therapy
Prospective Studies
Pulmonology and respiratory tract
Risk Factors
Time-to-Treatment
Empyema
Community-acquired pneumonia
Parapneumonic effusion
Lung abscess
Non-steroidal anti-inflammatory drug
ISSN:0341-2040, 1432-1750, 1432-1750
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Summary:Purpose Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed or used as self-medication in cases of community-acquired pneumonia (CAP). Nevertheless, the consequences of such medication on the risk of pleuroparenchymal complications are not well known. The aim was to investigate whether exposure to NSAIDs prior to hospital admission among patients suffering from CAP is associated with the development of pleural complications or a lung abscess. Methods All consecutive non-immunocompromised patients with CAP and admitted to a university hospital were prospectively included (2-year period). The risk of pleuropulmonary complications was analyzed according to previous exposure to NSAIDs. Results Of the 221 included patients, 40 (18.1%) had developed a pleuropulmonary complication. NSAIDs intake prior to admission was reported for 24 patients (10.9%) who were younger (50.6 ± 18.5 vs. 66.5 ± 16.4 years; p  = 0.001), had less comorbidities (60 vs. 25.1%; p  = 0.001), had a longer duration between the first symptoms of CAP and the start of an antibiotic therapy (6.1 ± 7.6 vs. 2.8 ± 3.8 days; p  = 0.001), and who had a higher incidence of pleuropulmonary complications (33.3 vs. 16.2%; p  = 0.048). In multivariate analyses, two factors were independently associated with the development of pleuroparenchymal complications: NSAIDs intake [Odds Ratio (OR) = 2.57 [1.02–6.64]; p  = 0.049] and alcohol abuse (OR = 2.68 [1.27–5.69]; p  = 0.01). Conclusions Our findings suggest that NSAIDs, often taken by young and healthy patients, may worsen the course of CAP with delayed therapy and a higher rate of pleuropulmonary complications.
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ISSN:0341-2040
1432-1750
1432-1750
DOI:10.1007/s00408-016-9973-1