The aim of this study was to determine whether the incidence of pneumonia in patients taking clozapine was more frequent compared with those taking risperidone or no atypical antipsychotics at all before admission to a tertiary care medical center. This was a retrospective, case-matched study of 465 general medicine patients over a 25 month period from 1 July 2010 to 31 July 2012. Detailed electronic medical records were analyzed to explore the association between the use of two atypical antipsychotics and incidence of pneumonia. Of the 155 patients in the clozapine group, 54 (34.8%) had documented pneumonia compared with 22 (14.2%) in the risperidone group and 18 (11.6%) in the general population group. Clozapine, when compared with the untreated general population, was associated with an increased risk of pneumonia (odds ratio=4.07; 95% confidence interval=2.25-7.36). There was, however, no significant increase in the risk of pneumonia associated with the use of risperidone (odds ratio=1.26; 95% confidence interval=0.65-2.45). Clozapine use is associated with increased risk of pneumonia that may be related to immunologic factors or side effects of sedation and drooling that make aspiration more likely, although causative mechanisms require further investigation. These findings suggest that providers should use added caution in choosing candidates for clozapine therapy.

中文翻译：

---

与利培酮和普通人群相比，氯氮平的使用增加了肺炎的发病率：回顾性比较在25个月内在一家医院中使用的氯氮平，利培酮和普通人群。

这项研究的目的是确定在进入三级医疗中心之前，服用氯氮平的患者与服用利培酮或完全不使用非典型抗精神病药的患者相比，肺炎的发生率是否更高。这是一项病例回顾性研究，从2010年7月1日至2012年7月31日的25个月内对465名普通医学患者进行了分析。对详细的电子病历进行了分析，以探讨两种非典型抗精神病药的使用与肺炎发生率之间的关系。在氯氮平组的155例患者中，有54例（34.8％）确诊为肺炎，而利培酮组为22例（14.2％），普通人群为18例（11.6％）。与未经治疗的普通人群相比，氯氮平与肺炎的风险增加相关（赔率= 4.07；95％置信区间= 2.25-7.36）。但是，与使用利培酮相关的肺炎风险没有显着增加（几率= 1.26； 95％置信区间= 0.65-2.45）。氯氮平的使用会增加肺炎的风险，这可能与免疫学因素或镇静和流口水的副作用有关，更可能导致误吸，尽管其致病机制尚需进一步研究。这些发现表明，提供者在选择氯氮平治疗的候选人时应格外谨慎。氯氮平的使用会增加肺炎的风险，这可能与免疫学因素或镇静和流口水的副作用有关，更可能导致误吸，尽管其致病机制尚需进一步研究。这些发现表明，提供者在选择氯氮平治疗的候选人时应格外谨慎。氯氮平的使用会增加肺炎的风险，这可能与免疫学因素或镇静和流口水的副作用有关，更可能导致误吸，尽管其致病机制尚需进一步研究。这些发现表明，提供者在选择氯氮平治疗的候选人时应格外谨慎。