C. diff patients on opioids face higher readmission risk, longer hospital stay

Over three-fourths of patients with Clostridium difficile receive opioids while hospitalized — but these painkillers increase the risk for severe disease, longer hospitalization and higher readmission rates, according to research published in Gastroenterology.

"We know opioids slow the gut, and slowing of the gut causes an alteration of microbiome of the gut, which is one big thing that predisposes patients to C. difficile," study author Monica Chowdhry, MD, told Medscape Medical News.

"We understand that patients with C. difficile can have acute pain in the abdomen," Dr. Chowdhry said, "but we were surprised to see that opioids can cause prolonged hospitalization and worsening of disease."

The research team conducted a retrospective analysis of 209 patients with C. diff in one hospital over a two-year period. Of these patients, 161 (77 percent) were taking opioids. These patients were prescribed the drugs either during or before hospitalization.

The study found patients in the opioid group were more likely to experience a severe case of C. diff than those in the nonopioid group — about 59 percent versus about 38 percent, respectively.

Additionally, the mean hospital stay was 63 percent longer in the opioid group than in the nonopioid group (nearly 15 days versus about 9 days). The rate of hospital readmission was also higher in the opioid group (about 38 percent versus about 22 percent), and more patients in the study's opioid group had stayed overnight in a healthcare facility within the last three months (60 percent versus 46 percent).

"Minimizing the use of opioids, if not avoiding them completely, could lead to something as big as preventing prolonged hospitalizations in these patients and to better patient care," Dr. Chowdhry said.

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