Association of Prescription Opioid Use and Development of Infectious Diseases: A Systematic Review

Date

2021

Authors

Ra, Jennifer

ORCID

0000-0002-6953-4137 (Ra, Jennifer)

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Abstract

Purpose: Recent studies have demonstrated an increased risk of infection associated with opioid use. The objective of this systematic review is to gather and compare evidence related to prescription opioids and development of infection. Methods The protocol for this systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) guidelines and was registered on PROSPERO (CRD42020205591). Studies about appropriate use of prescription opioids and subsequent development of infectious diseases were identified through an electronic search of PubMed, Embase, CINAHL complete, and Scopus databases. Inclusion criteria were adult patients with a prescription opioid who subsequently developed an infection. Exclusion criteria were studies related to pregnancy, human immunodeficiency virus (HIV), hepatitis C infection. Studies including prescription opioid misuse, overdose, or illicit or schedule I controlled substances were also ineligible. Results This systematic review yielded 25 studies that were highly variable in study design and target populations. Some studies included patients with immunocompromised states such as cancer and others included post-surgical populations or other disease states. The majority of studies established a correlation between prescription opioid use and risk of developing an infectious disease. Other trends associated with an increased risk of infection were current or recent use of opioids, extended-release opioid formulations, higher total daily morphine equivalents, and longer half-lives of opioids. Conclusion This systematic review showed a potential association between opioid use and acquirement of infectious diseases. Further randomized controlled trials are needed to validate these results.

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Research Appreciation Day Award Winner - 2021 UNT System College of Pharmacy Clinical/Outcomes Research Award - 2nd Place

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