Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
Journal website https://www.gastrores.org

Original Article

Volume 14, Number 5, October 2021, pages 275-280

Beyond Pain Relief: Is Opioids Use Safe in Clostridium difficile Infection?

Figures

Figure 1.
Figure 1. Severity of CDI (percentage of patients with severe disease) on day 4 of hospitalization in patients receiving opioids for pain versus controls. CDI: Clostridium difficile infection.
Figure 2.
Figure 2. Predicted probability of total number of complications in patients with CDI receiving opioids for pain control. CDI: Clostridium difficile infection.
Figure 3.
Figure 3. Disposition of patients with CDI who received opioids for pain versus controls. CDI: Clostridium difficile infection.

Tables

Table 1. Opioids Conversion to MME
 
AnalgesicRoute of administrationDoseMME
MME: morphine milligram equivalent.
MorphineParenteral1 mg3 mg
HydromorphoneParenteral1.5 mg30 mg
HydromorphoneOral7.5 mg30 mg
FentanylParenteral1 µg300 mg
FentanylTransdermal100 µg200 mg
HydrocodoneOral1 mg1 mg

 

Table 2. Primary and Secondary Outcomes of CDI in Control and Opioid Groups
 
OutcomeOpioid groupControl groupP-value
CDI: Clostridium difficile infection; LOS: length of stay.
Severe CDI78 (46.1%)37 (24%)< 0.001
Complicated CDI47 (27.8%)25 (16.4%)0.01
LOS (days)13 (6 - 18)7 (5 - 11)< 0.001
Hospital mortality29 (17%)13 (9%)0.022
Home disposition57 (33%)71 (47%)0.04

 

Table 3. Baseline Characteristics of Patients in Opioid Group and Controls
 
Baseline characteristicsOpioid groupControl groupP-value
CDI: Clostridium difficile infection; PPI: proton pomp inhibitor.
Age71 (58 - 81)76 (63 - 82)0.115
Male62 (37%)64 (42%)0.321
White124 (73%)121 (80%)0.20
Hospital acquired CDI72 (43%)62 (41%)0.42
Antibiotic use58 (34%)57 (38%)0.553
PPI use76 (45%)67 (44%)0.87
H2-blocker use9 (5%)12 (11%)0.08
Cirrhosis8 (5%)2 (1%)0.1
Malignancy42 (25%)32 (21%)0.42
Previous history of CDI36 (21%)33 (22%)0.92
Nursing home resident35 (21%)30 (20%)0.82
Immunosuppression24 (14%)18 (12%)0.53
Diabetes mellitus64 (38%)48 (32%)0.23
Chronic kidney disease29 (17%)43 (28%)0.017
Congestive heart failure21 (12%)31 (20%)0.053