title: Contribution of Opiate Analgesics to the Development of Infections in Advanced Cancer Patients.
abstract: Literature is limited on the relationship between opiate analgesics and the development of infections in cancer patients. This study aimed to determine whether opiate analgesics contribute to the advancement of infections and how infection rates differ among the various opiates used for cancer management.
  
  
  
  From January 2013 to October 2014, we analyzed retrospectively 642 consecutive advanced cancer patients who received single types of opiates, including morphine, oxycodone, or fentanyl, or a combination of these drugs, continuously for >14 days. Binominal logistic regression analysis was used to analyze the factors that may promote the development of infections.
  
  
  
  A total of 303 patients were included in the final analysis. Of these patients, 85, 41, and 68 patients received only morphine, oxycodone, and fentanyl, respectively. Altogether, 87 (28.7%) patients developed infections; 20 (23.5%), 10 (24.4%), and 14 (20.6%) patients developed infections in the groups that received only morphine, oxycodone, and fentanyl, respectively (P>0.05). Logistic regression analysis found that the daily oral morphine equivalent (OME) is the an independent factor that influences the development of infection in the single-opiate group (odds ratio=1.002, P<0.01). The risk for developing infection increased by 2% per 10 mg increase in the daily OME.
  
  
  
  Our clinical results did not display any difference among the single-opiate groups in the development of infections. However, the increase in daily OME may serve as a risk factor for the development of infections in advanced cancer patients using one opiate type for pain management.
authors.affiliation: Department of Pain Management and Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, P.R. China.
authors.forename: Yue-Juan
authors.initials: YJ
authors.lastname: Shao
authors.forename: Wei-Shuai
authors.initials: WS
authors.lastname: Liu
authors.forename: Bing-Qing
authors.initials: BQ
authors.lastname: Guan
authors.forename: Jian-Lei
authors.initials: JL
authors.lastname: Hao
authors.forename: Kai
authors.initials: K
authors.lastname: Ji
authors.forename: Xian-Jiang
authors.initials: XJ
authors.lastname: Cheng
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005283:Fentanyl / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D010098:Oxycodone / Q000009:adverse effects / Q000627:therapeutic use; D059408:Pain Management; D010166:Palliative Care; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D010098:Oxycodone; D005283:Fentanyl