The use of benzodiazepines is associated with an added accident of developing and dying of pneumonia, according to a new study.
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Benzodiazepines are frequently assigned for anxiety, epilepsy, beef spasm, and insomnia. They are additionally acclimated in booze care, as a sedative, and to advice bodies who are absorbed to booze stop drinking.
The authors fatigued that although their case-control abstracts appearance an affiliation amid benzodiazepine use and added accident for the accident of and bloodshed from community-acquired pneumonia, the award requires acceptance in a -to-be study.
In the meantime, "Doctors should assure their patients that while the abstraction is evocative of harm, it is not absolute and added advice is bare on the assurance of benzodiazepine drugs," coauthor Robert Sanders, MD, from the Institute of Cognitive Neuroscience, University College London, United Kingdom (UK) told Medscape Medical News.
"If patients ambition to stop their medication they should altercate this with their physician," he added. "I would like this abstraction to activate -to-be studies, including randomized controlled trials and accomplice studies in this area."
Their address is appear online December 5 in Thorax.
Susceptibility to Infection
In the UK and the United States, about 2% of the citizenry accept taken benzodiazepines for at atomic 12 months, and their use is alike added accustomed in the elderly, in whom use has been estimated to be as aerial as 10%, the abstraction authors, led by Eneanya Obiora, MD, from the University of Nottingham, UK, write.
"Accumulating preclinical and analytic abstracts advance that benzodiazepines may access susceptibility to infection, but little is accepted about the allowed furnishings in bodies of subsedative doses of benzodiazepines," Dr. Sanders said.
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Dr. Robert Sanders
In the accepted study, the advisers approved to actuate whether these frequently acclimated drugs, accurately diazepam, chlordiazepoxide, lorazepam, and temazepam, were associated with an added accident for pneumonia.
They analyzed the bloom annal of patients whose abstracts were entered into the Bloom Improvement Network, a primary affliction accommodating database that contains the annal of added than 9 actor patients from primary affliction practices beyond the UK.
They focused on 4964 patients with an adventure analysis of community-acquired pneumonia amid 2001 and 2002 and compared them with 29,697 age- and sex-matched controls.
After acclimation for a array of confounders (including accepted smoking, attendance of lung disease, analysis of abasement or psychosis, myocardial infarction, and antecedent adventure of pneumonia), benzodiazepine use was associated with a 54% accident of developing pneumonia (odds ratio, 1.54; 95% aplomb breach [CI], 1.42 - 1.67; P < .001).
Use of benzodiazepines was additionally associated with an added accident of dying of pneumonia at 30 days, as apparent by a hazard arrangement (HR) of 1.22 (95% CI, 1.06 - 1.39; P = .004), or aural 3 years of analysis (HR, 1.32; 95% CI, 1.19 - 1.47; P < .001).
Individually, chlordiazepoxide was not associated with an added accident of community-acquired pneumonia, but it was affiliated to an added accident of dying of pneumonia.
Dr. Sanders appropriate one accessible acumen for the benzodiazepine-pneumonia link.
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"Our alive antecedent is that the allowed furnishings of benzodiazepines are affiliated to gamma-aminobutyric acerbic blazon A, GABA-A, receptors that are bidding on neurons and allowed cells," he said.
Benzodiazepine Pneumonia Articulation Arresting and Surprising
Medscape Medical News arrive immunologist and pulmonologist Gregory E. Holt, MD, PhD, from the University of Miami Miller School of Medicine, Florida, to animadversion on this study.
Calling the abstraction "intriguing," Dr. Holt accepted that he was "a little surprised" to see that benzodiazepines had an aftereffect on the allowed system.
Dr. Gregory E. Holt
"I had never heard of that before, and back I looked it up, the abstracts wasn't as able as the abstraction authors appetite to accomplish it sound, that there is article accepted about benzodiazepines causing specific allowed problems," he said.
One backbone of the abstraction was its ample database. However, a limitation was that the abstracts were based on analysis codes as entered by the physician, Dr. Holt noted.
"Everything is coded based on what the physician puts in as a analysis code. There's consistently some problems with accepting all of the abstracts from that, but accustomed the limitations of what you can do with such a citizenry study, this was adequately able-bodied done," he said.
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"The alternation amid benzodiazepine use and pneumonia is there. The hazard ratios aren't cool high, the abstraction shows that there seems to be article to it, but this is a allusive study, not a adroit study."
Also arresting is the acumen for the articulation amid benzodiazepine use and pneumonia that the authors accept suggested, Dr. Holt remarked.
"The aftereffect of benzodiazepines acting through the GABA receptor on the allowed beef may be one of the things causing this access in pneumonia. However, addition acumen may be due to the actuality that these medications can abatement patients' sensorium so that they are sedated. In those cases, bodies do accept a harder time attention their airways, they may aspirate further, and that may be one account of the added adventitious of pneumonia," he said.
Like the abstraction authors, Dr. Holt said a prospective, adroit abstraction would be "ideal" to actuate causality, but such a abstraction would be actual difficult to do.
"In lieu of that, doctors charge to be abiding they are application these medications wisely. The benzodiazepines are a abundant chic of medications, but abominably the bigger activity through allure abstraction of a lot of accepted medication acceptance is affliction people, and this may aloof be one archetype of it," he said. "If patients charge a benzodiazepine, they should use them, but we charge to amusement the absolute accommodating and accede what we charge to do to get this accommodating off of these drugs," he said.
Dr. Sanders and Dr. Holt accept appear no accordant banking relationships.
Thorax. Appear online December 5, 2012. Abstract
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