The effect of prescribing antibiotics with opioids on the development of opioid use disorder: a national database study
The effect of prescribing antibiotics with opioids on the development of opioid use disorder: a national database study
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DOI：
10.1080/10550887.2021.1926889
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发表时间：
2021-05-07
影响因子：
2.3
通讯作者：
Graziane, Nicholas M.
中科院分区：
文献类型：
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作者：
Freedman, Zachary G.;Kane, Jennifer A.;Graziane, Nicholas M.
本研究的目的是检查住院或急诊科处方的抗生素治疗联合阿片类药物对出院后12个月发生阿片类药物使用障碍风险的影响。作者使用TriNetX研究网络数据库的数据进行了一项倾向评分匹配队列研究，以确定既往无阿片类药物使用障碍史的成年受试者（18-65岁）。分析定义了三个队列：2012年至2018年在急诊科或住院部接受阿片类药物、阿片类药物联合抗生素或抗生素处方的受试者。然后在ICD-10程序编码系统确定的索引事件后，在队列中观察从急诊科或住院部出院后12个月阿片类药物相关疾病（F11.10-F11.20）的诊断。初步分析（与年龄和性别相匹配的倾向评分）显示，阿片类药物与抗生素联合使用对阿片类药物使用障碍的发展具有保护作用。该效应在本研究纳入的所有年份中一致，2018年观察到的保护效应最小（2012年风险比= 1.27（95% CI：1.23，1.32）; 2018年风险比：1.03（95% CI：1.01，1.05）。这些发现表明，在医院环境中与抗生素联合使用的阿片类药物可以在出院后的较晚时间点预防OUD的发展。
The goal of this study was to examine the impact of inpatient- or emergency department- prescribed antibiotic treatment in combination with opioids on the risk of developing opioid use disorder 12 months following discharge from the hospital. The authors conducted a propensity score-matched cohort study with data from the TriNetX Research Network database to identify adult subjects (18-65 years old) with no previous history of an opioid use disorder. Three cohorts were defined for the analyses: subjects who were prescribed an opioid, opioid in combination with an antibiotic, or an antibiotic while in the emergency department or inpatient unit, from the years 2012 to 2018. The diagnosis of an Opioid Related Disorder (F11.10-F11.20) 12 months following discharge from the emergency department or inpatient unit was then observed within the cohorts following the index event as identified by the ICD-10 procedural coding system. Primary analysis (propensity-score matched on age and sex) showed that opioids prescribed in combination with antibiotics had a protective effect against the development of opioid use disorder. This effect was consistent throughout all of the years included in this study with the smallest protective effect observed in 2018 (2012 risk ratio = 1.27 (95% CI: 1.23, 1.32); 2018 risk ratio: 1.03 (95% CI: 1.01, 1.05). These findings suggest that opioids prescribed in combination with antibiotics in the hospital setting are protective against the development of OUD at later time points following hospital discharge.