No increased infection risk with opioids for cancer pain
medwireNews: Opioid use is not associated with an increased risk for infections in immunocompromised patients with cancer and chemotherapy-induced neutropenia, suggests a case–control study.
As reported in JAMA Internal Medicine, opioids were administered to 17.4% of 2135 participants of the Cologne Cohort of Neutropenic Patients who had hospital-acquired infection (defined as fever ≥38°C, blood stream infection, pneumonia, or intensive care unit admission), and to a comparable 16.6% of 2135 matched inpatients without infection.
There was no significant association between opioid use and infection risk, regardless of whether the opioids were classed as having immunosuppressive properties (eg, diamorphine, fentanyl) or not (eg, oxycodone, tramadol).
Opioids with unknown immunosuppressive properties did appear to be associated with an increased risk, but this was primarily driven by meperidine, which is “a standard treatment for severe mucositis, an acknowledged infection risk,” explain the researchers.
Jörg Vehreschild (Goethe University Frankfurt, Germany) and co-authors note that their results are in contrast to a recent report showing an increased risk for community-acquired pneumonia in opioid-treated individuals with HIV.
They continue: “Further observation, ideally in a controlled prospective trial, is warranted before adapting current standards in cancer care.”
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