Opioid Analgesic Use and Risk for Invasive Pneumococcal Diseases: A Nested Case-Control Study

Area of Science:

• Infectious Diseases
• Epidemiology
• Pharmacology

Background:

• Opioid analgesics are known to have immunosuppressive effects in animals, increasing infection risk.
• The impact of prescription opioid use on human infection risk remains largely unknown.
• This study investigates the potential link between opioid use and invasive pneumococcal disease (IPD).

Purpose of the Study:

• To determine if prescription opioid use is an independent risk factor for invasive pneumococcal disease (IPD).

Main Methods:

• A nested case-control study was conducted using linked Tennessee Medicaid, Medicare, and Active Bacterial Core surveillance system databases (1995-2014).
• 1233 IPD case patients were matched with 24,399 control participants.
• Opioid use was assessed via pharmacy prescription fills, and IPD was defined by bacterial isolation from sterile sites.

Main Results:

• Current opioid users had significantly higher odds of developing IPD compared to non-users (aOR, 1.62).
• The association was stronger for long-acting, high-potency, and high-dosage opioids.
• Results remained consistent across sensitivity analyses, including those accounting for known IPD risk factors and stratifying by pneumonia status.

Conclusions:

• Prescription opioid use is associated with an increased risk of invasive pneumococcal disease (IPD).
• Opioid use represents a novel and significant risk factor for IPD.
• Further research is warranted to understand the mechanisms behind this association and its clinical implications.