Increased use of antibiotics in patients treated with clozapine.
Clozapine has the potential to cause agranulocytosis and an association to an increased risk of infections has been suggested. Patients with an ICD-10 F20.x were identified from the Danish Central Psychiatric Research Registry and were linked to the national prescription database to identify schizophrenia patients treated with clozapine from 1996 to 2005(N=3374). Binomial regression and Cox proportional hazards models were used. An increased use of antibiotics was found RR=1.43, CI: 1.26-1.61, P<0.0001 and HR 1.14, 95% CI: 1.05-1.24, P=0.0025 with binomial regression and Cox proportional hazard model, respectively. The exact mechanism for the increased risk remains unknown, but the increased risk might be due to aspiration pneumonia caused by hypersalivation and the sedating properties of clozapine. The findings reported here should alert clinicians to be mindful of infectious processes as yet another possible somatic manifestation of clozapine treatment.
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Mølleparkvej 10, PO Box 210, DK-9100 Aalborg, Denmark. jin@rn.dk
Jimmi
J
Nielsen
Leslie
L
Foldager
Jonathan M
JM
Meyer
D000380:Agranulocytosis / Q000139:chemically induced* / Q000188:drug therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects*; D003024:Clozapine / Q000009:adverse effects*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D016903:Drug Monitoring; D006801:Humans; D038801:International Classification of Diseases; D055656:Prescriptions / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D014150:Antipsychotic Agents; D003024:Clozapine