A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock
Tóm tắt
We aimed to establish whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) during evolving bacterial community-acquired infection in adults is associated with severe sepsis or septic shock. We conducted a multicentre case-control study in eight intensive care units. Cases were all adult patients admitted for severe sepsis or septic shock due to a bacterial community-acquired infection. Control individuals were patients hospitalized with a mild community-acquired infection. Each case was matched to one control for age, presence of diabetes and site of infection. The main outcome measures were the proportions of cases and controls exposed to NSAIDs or aspirin during the period of observation. In all, 152 matched pairs were analyzed. The use of NSAIDs or aspirin during the observation period did not differ between cases and controls (27% versus 28; odds ratio = 0.93, 95% confidence interval [CI] = 0.52 to 1.64). If aspirin was not considered or if a distinction was made between acute and chronic drug treatment, there remained no difference between groups. However, the median time to prescription of effective antibiotic therapy was longer for NSAID users (6 days, 95% CI = 3 to 7 days) than for nonusers (3 days, 95% CI = 2 to 3 days; P = 0.02). In this study, the use of NSAIDs or aspirin during evolving bacterial infection was frequent and occurred in one-quarter of the patients with such infection. Although the use of NSAIDs by patients with severe sepsis or septic shock did not differ from their use by those with mild infection at the same infected site, we observed a longer median time to prescription of effective antibiotic therapy in NSAID users.
Tài liệu tham khảo
Barnham MR, Weightman NC, Anderson AW, Tanna A: Streptococcal toxic shock syndrome: a description of 14 cases from North Yorkshire, UK. Clin Microbiol Infect 2002, 8: 174-181. 10.1046/j.1469-0691.2002.00396.x
Forbes N, Ranklin AP: Necrotizing fasciitis and non steroidal anti-inflammatory drugs: a case series and review of the literature. N Z Med J 2001, 114: 3-6.
Holder EP, Moore PT, Browne BA: Nonsteroidal anti-inflammatory drugs and necrotising fasciitis. An update. Drug Saf 1997, 17: 369-373. 10.2165/00002018-199717060-00003
Mulla ZD: Nonsteroidal anti-inflammatory drugs and hypotension among patients hospitalized for invasive Group A streptococcal disease. Ann Epidemiol 2003, 13: 543-4. 10.1016/S1047-2797(03)00071-1
Aronoff DM, Bloch KC: Assessing the relationship between the use of nonsteroidal antiinflammatory drugs and necrotizing fasciitis caused by group A streptococcus. Medicine 2003, 82: 225-235. 10.1097/00005792-200307000-00001
Stevens DL: Could nonsteroidal anti-inflammatory drugs (NSAIDs) enhance the progression of bacterial infections to toxic shock syndrome? Clin Infect Dis 1995, 21: 977-80.
Brun-Buisson CJ, Saada M, Trunet P, Rapin M, Roujeau JC, Revuz J: Haemolytic streptococcal gangrene and non-steroidal anti-inflammatory drugs. Br Med J (Clin Res Ed) 1985, 290: 1786. 10.1136/bmj.290.6484.1786
Rimailho A, Riou B, Richard C, Auzepy P: Fulminant necrotizing fasciitis and nonsteroidal anti-inflammatory drugs. J Infect Dis 1987, 155: 143-146.
Schummer W, Schummer C: Nonsteroidal anti-inflammatory drugs and streptococcal toxic shock syndrome. Intensive Care Med 2002, 28: 1194. 10.1007/s00134-002-1376-5
Veenstra RP, Manson WE, Werf TS, Fijen JW, Tulleken JE, Zijlstru JG, Ligtenberg JJM: Fulminant necrotizing fasciitis and nonsteroidal anti-inflammatory drugs. Intensive Care Med 2001, 27: 1831. 10.1007/s001340101070
Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, Schein RM, Sibbald WJ: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992, 101: 1644-1655. 10.1378/chest.101.6.1644
Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G: 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003, 31: 1250-1256. 10.1097/01.CCM.0000050454.01978.3B
Breslow NE, Day NE: Statistical Methods in Cancer Research. Volume I – The Analysis of Case-control Studies. Lyon, France: IARC Scientific Publications; 1987.
O'Brien PC, Fleming TR: A multiple testing procedure for clinical trials. Biometrics 1979, 35: 549-556. 10.2307/2530245
Gonzalez BE, Martinez-Aguilar G, Hulten KG, Hammerman WA, Coss-Bu J, Avalos-Mishaan A, Mason EO, Kaplan SL: Severe staphylococcal sepsis in adolescents in the era of community-acquired methicillin-resistant S. aureus . Pediatrics 2005, 115: 642-648. 10.1542/peds.2004-2300
Lesko SM, O'Brien KL, Schwartz B, Vezina R, Mitchell A: Invasive group A streptococcal infection and nonsteroidal antiinflammatory drug use among children with primary varicella. Pediatrics 2001, 107: 1108-1115. 10.1542/peds.107.5.1108
Peterson CL, Vugia DJ, Meyers HB, Chao SM, Vogt J, Lanson J, Brunell PA, Kim KS, Mascola L: Risk factors for invasive group A streptococcal infections in children with varicella: a case-control study. Pediatr Infect Dis J 1996, 15: 151-156. 10.1097/00006454-199602000-00012
Mikaeloff Y, Kezouh A, Suissa S: Nonsteroidal anti-inflammatory drug use and the risk of severe skin and soft tissue complications in patients with varicella or zoster disease. Br J Clin Pharmacol 2008, 65: 203-209. 10.1111/j.1365-2125.2007.02997.x
Zerr DM, Alexander ER, Duchin JS, Koutzky LA, Rubens CE: A case-control study of necrotizing fasciitis during primary varicella. Pediatrics 1999, 103: 783-790. 10.1542/peds.103.4.783
Vincent JL, Sakr Y, Sprung CL, Ranieri VM, Reinhart K, Gerlach H, Moreno R, Carlet J, Le Gall JR, Payen D, on behalf of the Sepsis Occurrence in Acutely Ill Patients Investigators: Sepsis in European intensive care units: results of the SOAP study. Crit Care Med 2006, 34: 344-353. 10.1097/01.CCM.0000194725.48928.3A
Fletcher JR: The effects of ibuprofen on eicosanoid synthesis in sepsis. Crit Care Med 1999, 27: 699-707. 10.1097/00003246-199904000-00001
Guibal F, Muffat-Joly M, Terris B, Garry L, Morel P, Carbon C: Effects of diclofenac on experimental streptococcal necrotizing fasciitis in rabbit. Arch Dermatol Res 1998, 290: 628-633. 10.1007/s004030050363
Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, Suppes R, Feinstein D, Zanotti S, Taiberg L, Gurka D, Kumar A, Cheang M: Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006, 34: 1589-1596. 10.1097/01.CCM.0000217961.75225.E9
Bernard GR, Wheeler AP, Russell JA, Schein R, Summer WR, Steinberg KP, Fulkerson WJ, Wright PE, Christman BW, Dupont WD, Higgins SB, Swindell BB, for the Ibuprofen in Sepsis Study Group: The effects of ibuprofen on the physiology and survival of patients with sepsis. N Engl J Med 1997, 336: 912-918. 10.1056/NEJM199703273361303
Haupt MT, Jastremski MS, Clemmer TP, Metz CA, Goris GB, the Ibuprofen Study Group: Effect of ibuprofen in patients with severe sepsis: a randomized double blind study. Crit Care Med 1991, 19: 1339-1347.
Memis D, Karamanlioglu B, Turan A, Koyuncu O, Pamukcu Z: Effects of lornoxicam on the physiology of severe sepsis. Crit Care 2004, 8: R474-R482. 10.1186/cc2969
Coran AG, Drongowski RA, Paik JJ, Remick DG: Ibuprofen intervention in canine septic shock: reduction of pathophysiology without decreased cytokines. J Surg Res 1992, 53: 272-279. 10.1016/0022-4804(92)90047-4
Martich GD, Danner RL, Ceska M, Suffredini F: Detection of IL8 and TNF in normal humans after IV endotoxin: the effect of antiinflammatory agents. J Exp Med 1991, 173: 1021-1024. 10.1084/jem.173.4.1021