Benzodiazepines and related drugs: pneumonia

In a large case-control study using data from a British primary care database, exposure to a benzodiazepine or the related sedative drug zopiclone during the previous month was more frequent in patients with community-acquired pneumonia than in controls, with an odds ratio of about 1.5. In the cohort of patients with community-acquired pneumonia, exposure to a benzodiazepine was associated with a statistically significant increase in long-term mortality (median follow-up 2.8 years) following pneumonia, with odds ratios of about 1.2 and 1.3, respectively. Benzodiazepines can provoke swallowing disorders, cough suppression and respiratory depression. In practice, despite the uncertainties, these data provide yet another reason to avoid overprescribing these drugs, to carefully weigh the benefits against the harms before initiating treatment, and to regularly review the harm-benefit balance.