The association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using UK Primary Care data
Purpose: Bacterial superinfections, including pneumonia, are frequent complications of influenza-like illness (ILI). Clinical and laboratory evidence suggests that benzodiazepines and Z-drugs may influence susceptibility to infections and mortality. We investigated whether benzodiazepines and zopicl...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Published: |
Wiley
2016
|
| Subjects: | |
| Online Access: | https://eprints.nottingham.ac.uk/34139/ |
| _version_ | 1848794782512447488 |
|---|---|
| author | Nakafero, Georgina Sanders, Robert D. Nguyen-Van-Tam, Jonathan S. Myles, Puja R. |
| author_facet | Nakafero, Georgina Sanders, Robert D. Nguyen-Van-Tam, Jonathan S. Myles, Puja R. |
| author_sort | Nakafero, Georgina |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Purpose: Bacterial superinfections, including pneumonia, are frequent complications of influenza-like illness (ILI). Clinical and laboratory evidence suggests that benzodiazepines and Z-drugs may influence susceptibility to infections and mortality. We investigated whether benzodiazepines and zopiclone modify the occurrence of ILI-related pneumonia and mortality.
Methods: We obtained data on 804 051 ILI patients from a comprehensive primary care database, the Clinical Practice Research Datalink. The follow-up period started from the diagnosis of ILI for 30 days. Pneumonia and deaths occurring within the 30-day follow-up period were considered as potentially ‘ILI related’. Exposure to benzodiazepines and zopiclone was determined in the period preceding a diagnosis of ILI with current use defined as a prescription for benzodiazepines in the month prior to ILI diagnosis. Cox regression was used for the analyses. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) are presented.
Results: Influenza-like illness-related pneumonia and mortality were noted in 1117 and 707 ILI patients, respectively. Current exposure to benzodiazepines was associated with increased occurrence of both ILI-related pneumonia and mortality (ILI-related pneumonia adjusted HR 4.24, 95%CI [2.27, 7.95]; ILI-related mortality adjusted HR 20.69, 95%CI [15.54, 27.54]). A similar increase in ILI-related mortality but not pneumonia was observed with current zopiclone use (ILI-related mortality adjusted HR 10.86, 95%CI [6.93, 17.02]; ILI-related pneumonia adjusted HR 1.97, 95%CI [0.63, 6.12]).
Conclusion: Benzodiazepines may increase the likelihood of pneumonia and mortality related to ILI. A cautionary approach to prescribing benzodiazepine is suggested in people known to be at increased risk of pneumonia or mortality. |
| first_indexed | 2025-11-14T19:21:40Z |
| format | Article |
| id | nottingham-34139 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:21:40Z |
| publishDate | 2016 |
| publisher | Wiley |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-341392020-05-04T17:50:55Z https://eprints.nottingham.ac.uk/34139/ The association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using UK Primary Care data Nakafero, Georgina Sanders, Robert D. Nguyen-Van-Tam, Jonathan S. Myles, Puja R. Purpose: Bacterial superinfections, including pneumonia, are frequent complications of influenza-like illness (ILI). Clinical and laboratory evidence suggests that benzodiazepines and Z-drugs may influence susceptibility to infections and mortality. We investigated whether benzodiazepines and zopiclone modify the occurrence of ILI-related pneumonia and mortality. Methods: We obtained data on 804 051 ILI patients from a comprehensive primary care database, the Clinical Practice Research Datalink. The follow-up period started from the diagnosis of ILI for 30 days. Pneumonia and deaths occurring within the 30-day follow-up period were considered as potentially ‘ILI related’. Exposure to benzodiazepines and zopiclone was determined in the period preceding a diagnosis of ILI with current use defined as a prescription for benzodiazepines in the month prior to ILI diagnosis. Cox regression was used for the analyses. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) are presented. Results: Influenza-like illness-related pneumonia and mortality were noted in 1117 and 707 ILI patients, respectively. Current exposure to benzodiazepines was associated with increased occurrence of both ILI-related pneumonia and mortality (ILI-related pneumonia adjusted HR 4.24, 95%CI [2.27, 7.95]; ILI-related mortality adjusted HR 20.69, 95%CI [15.54, 27.54]). A similar increase in ILI-related mortality but not pneumonia was observed with current zopiclone use (ILI-related mortality adjusted HR 10.86, 95%CI [6.93, 17.02]; ILI-related pneumonia adjusted HR 1.97, 95%CI [0.63, 6.12]). Conclusion: Benzodiazepines may increase the likelihood of pneumonia and mortality related to ILI. A cautionary approach to prescribing benzodiazepine is suggested in people known to be at increased risk of pneumonia or mortality. Wiley 2016-05-23 Article PeerReviewed Nakafero, Georgina, Sanders, Robert D., Nguyen-Van-Tam, Jonathan S. and Myles, Puja R. (2016) The association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using UK Primary Care data. Pharmacoepidemiology and Drug Safety . ISSN 1099-1557 benzodiazepines zopiclone influenza-like illness pneumonia mortality pharmacoepidemiology http://onlinelibrary.wiley.com/doi/10.1002/pds.4028/abstract doi:10.1002/pds.4028 doi:10.1002/pds.4028 |
| spellingShingle | benzodiazepines zopiclone influenza-like illness pneumonia mortality pharmacoepidemiology Nakafero, Georgina Sanders, Robert D. Nguyen-Van-Tam, Jonathan S. Myles, Puja R. The association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using UK Primary Care data |
| title | The association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using UK Primary Care data |
| title_full | The association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using UK Primary Care data |
| title_fullStr | The association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using UK Primary Care data |
| title_full_unstemmed | The association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using UK Primary Care data |
| title_short | The association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using UK Primary Care data |
| title_sort | association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using uk primary care data |
| topic | benzodiazepines zopiclone influenza-like illness pneumonia mortality pharmacoepidemiology |
| url | https://eprints.nottingham.ac.uk/34139/ https://eprints.nottingham.ac.uk/34139/ https://eprints.nottingham.ac.uk/34139/ |