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A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock

INTRODUCTION: We aimed to establish whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) during evolving bacterial community-acquired infection in adults is associated with severe sepsis or septic shock. METHODS: We conducted a multicentre case-control study in eight intensive care units...

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Autores principales: Legras, Annick, Giraudeau, Bruno, Jonville-Bera, Annie-Pierre, Camus, Christophe, François, Bruno, Runge, Isabelle, Kouatchet, Achille, Veinstein, Anne, Tayoro, Jérome, Villers, Daniel, Autret-Leca, Elisabeth
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689487/
https://www.ncbi.nlm.nih.gov/pubmed/19331665
http://dx.doi.org/10.1186/cc7766
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author Legras, Annick
Giraudeau, Bruno
Jonville-Bera, Annie-Pierre
Camus, Christophe
François, Bruno
Runge, Isabelle
Kouatchet, Achille
Veinstein, Anne
Tayoro, Jérome
Villers, Daniel
Autret-Leca, Elisabeth
author_facet Legras, Annick
Giraudeau, Bruno
Jonville-Bera, Annie-Pierre
Camus, Christophe
François, Bruno
Runge, Isabelle
Kouatchet, Achille
Veinstein, Anne
Tayoro, Jérome
Villers, Daniel
Autret-Leca, Elisabeth
author_sort Legras, Annick
collection PubMed
description INTRODUCTION: We aimed to establish whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) during evolving bacterial community-acquired infection in adults is associated with severe sepsis or septic shock. METHODS: We conducted a multicentre case-control study in eight intensive care units. Cases were all adult patients admitted for severe sepsis or septic shock due to a bacterial community-acquired infection. Control individuals were patients hospitalized with a mild community-acquired infection. Each case was matched to one control for age, presence of diabetes and site of infection. RESULTS: The main outcome measures were the proportions of cases and controls exposed to NSAIDs or aspirin during the period of observation. In all, 152 matched pairs were analyzed. The use of NSAIDs or aspirin during the observation period did not differ between cases and controls (27% versus 28; odds ratio = 0.93, 95% confidence interval [CI] = 0.52 to 1.64). If aspirin was not considered or if a distinction was made between acute and chronic drug treatment, there remained no difference between groups. However, the median time to prescription of effective antibiotic therapy was longer for NSAID users (6 days, 95% CI = 3 to 7 days) than for nonusers (3 days, 95% CI = 2 to 3 days; P = 0.02). CONCLUSIONS: In this study, the use of NSAIDs or aspirin during evolving bacterial infection was frequent and occurred in one-quarter of the patients with such infection. Although the use of NSAIDs by patients with severe sepsis or septic shock did not differ from their use by those with mild infection at the same infected site, we observed a longer median time to prescription of effective antibiotic therapy in NSAID users.
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spelling pubmed-26894872009-06-02 A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock Legras, Annick Giraudeau, Bruno Jonville-Bera, Annie-Pierre Camus, Christophe François, Bruno Runge, Isabelle Kouatchet, Achille Veinstein, Anne Tayoro, Jérome Villers, Daniel Autret-Leca, Elisabeth Crit Care Research INTRODUCTION: We aimed to establish whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) during evolving bacterial community-acquired infection in adults is associated with severe sepsis or septic shock. METHODS: We conducted a multicentre case-control study in eight intensive care units. Cases were all adult patients admitted for severe sepsis or septic shock due to a bacterial community-acquired infection. Control individuals were patients hospitalized with a mild community-acquired infection. Each case was matched to one control for age, presence of diabetes and site of infection. RESULTS: The main outcome measures were the proportions of cases and controls exposed to NSAIDs or aspirin during the period of observation. In all, 152 matched pairs were analyzed. The use of NSAIDs or aspirin during the observation period did not differ between cases and controls (27% versus 28; odds ratio = 0.93, 95% confidence interval [CI] = 0.52 to 1.64). If aspirin was not considered or if a distinction was made between acute and chronic drug treatment, there remained no difference between groups. However, the median time to prescription of effective antibiotic therapy was longer for NSAID users (6 days, 95% CI = 3 to 7 days) than for nonusers (3 days, 95% CI = 2 to 3 days; P = 0.02). CONCLUSIONS: In this study, the use of NSAIDs or aspirin during evolving bacterial infection was frequent and occurred in one-quarter of the patients with such infection. Although the use of NSAIDs by patients with severe sepsis or septic shock did not differ from their use by those with mild infection at the same infected site, we observed a longer median time to prescription of effective antibiotic therapy in NSAID users. BioMed Central 2009 2009-03-30 /pmc/articles/PMC2689487/ /pubmed/19331665 http://dx.doi.org/10.1186/cc7766 Text en Copyright © 2009 Legras et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Legras, Annick
Giraudeau, Bruno
Jonville-Bera, Annie-Pierre
Camus, Christophe
François, Bruno
Runge, Isabelle
Kouatchet, Achille
Veinstein, Anne
Tayoro, Jérome
Villers, Daniel
Autret-Leca, Elisabeth
A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock
title A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock
title_full A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock
title_fullStr A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock
title_full_unstemmed A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock
title_short A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock
title_sort multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689487/
https://www.ncbi.nlm.nih.gov/pubmed/19331665
http://dx.doi.org/10.1186/cc7766
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