Abstract

The goal of this study was to examine the impact of inpatient- or emergency department- prescribed antibiotic treatment in combination with opioids on the risk of developing opioid use disorder 12 months following discharge from the hospital. The authors conducted a propensity score-matched cohort study with data from the TriNetX Research Network database to identify adult subjects (18–65 years old) with no previous history of an opioid use disorder. Three cohorts were defined for the analyses: subjects who were prescribed an opioid, opioid in combination with an antibiotic, or an antibiotic while in the emergency department or inpatient unit, from the years 2012 to 2018. The diagnosis of an Opioid Related Disorder (F11.10–F11.20) 12 months following discharge from the emergency department or inpatient unit was then observed within the cohorts following the index event as identified by the ICD-10 procedural coding system. Primary analysis (propensity-score matched on age and sex) showed that opioids prescribed in combination with antibiotics had a protective effect against the development of opioid use disorder. This effect was consistent throughout all of the years included in this study with the smallest protective effect observed in 2018 (2012 risk ratio = 1.27 (95% CI: 1.23, 1.32); 2018 risk ratio: 1.03 (95% CI: 1.01, 1.05). These findings suggest that opioids prescribed in combination with antibiotics in the hospital setting are protective against the development of OUD at later time points following hospital discharge.

摘要

本研究的目的是检查住院或急诊科处方抗生素治疗联合阿片类药物对出院后 12 个月发生阿片类药物使用障碍风险的影响。作者使用来自 TriNetX 研究网络数据库的数据进行了一项倾向得分匹配的队列研究，以确定以前没有阿片类药物使用障碍史的成人受试者（18-65 岁）。为分析定义了三个队列：从 2012 年到 2018 年，在急诊科或住院部开具阿片类药物、阿片类药物联合抗生素或抗生素的受试者。阿片类药物相关疾病的诊断（F11 .10–F11。20) 然后在 ICD-10 程序编码系统确定的索引事件后的队列中观察从急诊科或住院病房出院后的 12 个月。初步分析（年龄和性别的倾向评分匹配）表明，与抗生素联合使用的阿片类药物对阿片类药物使用障碍的发展具有保护作用。这种效应在本研究所包括的所有年份中都是一致的，2018 年观察到的保护效应最小（2012 年风险比 = 1.27（95% CI：1.23，1.32）；2018 年风险比：1.03（95% CI：1.01，1.05） ). 这些研究结果表明，在医院环境中与抗生素联合使用的阿片类药物可以防止出院后后期出现 OUD。