The paper is a meta-analysis of four studies that together include almost 120,000 patients. Researchers report that about 31% of patients who were prescribed and were taking opioids developed C. diff, compared with 17% of patients who were not using opioids. The authors point out that known risks such as recent antibiotic use or a weakened immune system remain important, and opioid use may add to those risks.
Two mechanisms are described that could explain the link. First, opioids can suppress immune function, reducing the body’s ability to fight pathogens. Second, opioids can disturb the gut microbiome, changing the balance of beneficial bacteria that normally help prevent colonization by organisms like C. diff.
Coauthor Lorenzo Villa-Zapata said the evidence on the connection is mixed and that the aim is to give prescribers useful information. Lead author Pooja Gokhale said opioids "mess with the gut microbiome" and can lead to immunosuppression, increasing infection susceptibility. The researchers emphasise case-by-case prescribing: physicians should consider each patient’s history and current risk, since hospitalized or immunocompromised patients face higher danger. The study appears in the American Journal of Infection Control (source: University of Georgia).
Difficult words
- meta-analysis — study combining results from several different studies
- opioid — drug used to relieve pain that can be addictiveopioids
- microbiome — community of microorganisms living in the digestive tractgut microbiome
- immunosuppression — reduced activity of the body's immune system
- colonization — establishment and growth of organisms on a body surface
- prescriber — medical professional who issues prescriptions to patientsprescribers
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- How might the finding that opioids increase C. diff risk affect a doctor’s decision to prescribe them? Give reasons.
- What additional patient information would you want to know before prescribing opioids, based on the risks described?
- What steps could hospitals take to reduce infection risk in patients who need opioid treatment?
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