As opioid use has increased in the U.S., the safety of prescription opioids has come under further scrutiny. In animal studies, use of certain opioids has been associated with increased susceptibility to bacterial infections, including infectious due to Streptococcus pneumoniae, the pathogen that causes invasive pneumococcal disease. Invasive pneumococcal disease includes bacteremia, meningitis, and invasive pneumonia, all of which are associated with high mortality. Although those associations have been well established in animal experiments, it is important to understand the risk of serious infections among humans taking prescription opioid analgesics.

Researchers from The Vanderbilt University Medical Center used data from the Tennessee Medicaid database linked to Medicare and Active Bacterial Core surveillance system databases to test the hypothesis that prescription opioid use is an independent risk factor for invasive pneumococcal disease. They found a significant association between opioid use and the risk of laboratory-confirmed invasive pneumococcal diseases, and that this association was strongest for opioids used at high doses, those classified as high potency and long-acting formulations. The data also showed that opioids previously described as immunosuppressive in prior experimental studies conducted in animals had the strongest association with invasive pneumococcal diseases in humans.

According to the researchers, providers should consider these findings when discussing pain management with their patients.

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