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Anti-inflammatory drugs compound the results of pneumonia
Reuters 14/02/2011 16:32 Updated: 14/02/2011 17:35
By Karla Gale
Some major disadvantages nullified antipyretic and analgesic effects of nonsteroidal antiinflammatory drugs (NSAIDs) at the beginning of a serious lower respiratory tract infection, says a French team.
And that would delay the diagnosis of community-acquired pneumonia and complications more common.
Muriel Fartoukh team found that patients with community-acquired pneumonia treated with NSAIDs were five times more likely to develop pleural empyema or lung cavitation patients not receiving NSAIDs.
These drugs doubled the risk of bacteremia, as published in the journal Chest.
The study was conducted in the workplace of the authors, the Tenon Hospital in Paris, between 2002 and 2006.
The 90 patients were admitted to the intensive care unit (ICU) or intermediate care unit associated. We excluded patients with other diseases or under prolonged treatment with NSAIDs or steroids.
Thirty-two patients (36 percent) had taken NSAIDs alone or with antibiotics for five days before referral. In 16 patients had indicated they only antibiotics before admission.
The study shows that patients treated with NSAIDs tended to enter the hospital in a not so serious, according to physiological assessment scales (SAPS II) and determination of organ failure, sepsis (SOFA). But had a higher prevalence of chest pain and pleural syndrome, in addition to infiltrate and pleural effusions multilobular by radiography.
We recorded the cause of pneumonia in three quarters of patients, the majority were caused by Streptococcus pneumoniae, followed by Legionella and Pseudomonas aeruginosa. We identified four polymicrobial cases.
For the team, the causes were similar regardless of NSAID use or not. In both groups, pre-hospital use of antibiotics was adequate in less than half of cases.
In patients without antibiotic treatment before hospitalization, bacteremia was more common in the group treated with NSAIDs (69 versus 27 percent). NSAIDs were also associated with an increased rate of pleural empyema and lung cavitation (by 37.5 versus 7 percent).
After multivariate analysis, exposure to NSAIDs was the only independent predictor of pleuropulmonary complications and invasive disease in the absence of pre-hospital treatment with antibiotics.
NSAIDs significantly prolonged antimicrobial therapy and tended to extend in the ICU and hospital.
SOURCE: Chest, 2011