Pain killers: the interplay between nonsteroidal anti-inflammatory drugs and Clostridioides difficile infection

2022 ◽  
Vol 65 ◽  
pp. 167-174
Joshua Soto Ocaña ◽  
Nile U Bayard ◽  
Joseph P Zackular
Travis J Carlson ◽  
Anne J Gonzales-Luna ◽  
Melissa F Wilcox ◽  
Sarah G Theriault ◽  
Faris S Alnezary ◽  

Abstract Objectives The pathogenesis of Clostridioides difficile infection (CDI) involves a significant host immune response. Generally, corticosteroids act by suppressing the host inflammatory response, and their anti-inflammatory effects are used to treat gastrointestinal disorders. Although previous investigations have demonstrated mixed results regarding the effect of corticosteroids on CDI, we hypothesized that the anti-inflammatory effect of corticosteroids would decrease the risk of CDI in hospitalized patients. Methods This was a case-control study of hospitalized adults. The case population included patients diagnosed with primary CDI who received at least one dose of a high-risk antibiotic (cefepime, meropenem, or piperacillin-tazobactam) in the 90 days prior to CDI diagnosis. The control population included patients who received at least one dose of the same high-risk antibiotic but did not develop CDI in the 90 days following their first dose of antibiotic. The primary study outcome was the development of CDI based on receipt of corticosteroids. Results The final study cohort consisted of 104 cases and 153 controls. Those who received corticosteroids had a lower odds of CDI after adjusting for age, proton-pump inhibitor use, and antibiotic days of therapy (OR, 0.54; 95% CI, 0.30 to 0.97; P=0.04). We did not observe an association between corticosteroid dose or duration and CDI. Conclusions We demonstrated a 46% relative reduction in the odds of developing CDI in patients who received corticosteroids in the past 90 days. We believe that our results provide the best clinical evidence to further support mechanistic studies underlying this phenomenon.

Planta Medica ◽  
2010 ◽  
Vol 76 (12) ◽  
V Francisco ◽  
A Figueirinha ◽  
B Neves ◽  
C Garcia-Rodriguez ◽  
M Lopes ◽  

1996 ◽  
Vol 16 (01) ◽  
pp. 56-59
D. J. Tyrrell ◽  
C. P. Page

SummaryEvidence continues to accumulate that the pleiotropic nature of heparin (beyond its anticoagulant potency) includes anti-inflammatory activities at a number of levels. It is clear that drugs exploiting these anti-inflammatory activities of heparin may offer exciting new therapeutic applications to the treatment of a wide range of inflammatory diseases.

This review paper covers the major synthetic approaches attempted towards the synthesis of some Non-Steroidal Anti-Inflammatory Drugs (Naproxen, Ibuprofen and Nabumetone)

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