title: Non-steroidal Anti-inflammatory Drugs may Worsen the Course of Community-Acquired Pneumonia: A Cohort Study.
abstract: Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed or used as self-medication in cases of community-acquired pneumonia (CAP). Nevertheless, the consequences of such medication on the risk of pleuroparenchymal complications are not well known. The aim was to investigate whether exposure to NSAIDs prior to hospital admission among patients suffering from CAP is associated with the development of pleural complications or a lung abscess.
  
  
  
  All consecutive non-immunocompromised patients with CAP and admitted to a university hospital were prospectively included (2-year period). The risk of pleuropulmonary complications was analyzed according to previous exposure to NSAIDs.
  
  
  
  Of the 221 included patients, 40 (18.1%) had developed a pleuropulmonary complication. NSAIDs intake prior to admission was reported for 24 patients (10.9%) who were younger (50.6 ± 18.5 vs. 66.5 ± 16.4 years; p = 0.001), had less comorbidities (60 vs. 25.1%; p = 0.001), had a longer duration between the first symptoms of CAP and the start of an antibiotic therapy (6.1 ± 7.6 vs. 2.8 ± 3.8 days; p = 0.001), and who had a higher incidence of pleuropulmonary complications (33.3 vs. 16.2%; p = 0.048). In multivariate analyses, two factors were independently associated with the development of pleuroparenchymal complications: NSAIDs intake [Odds Ratio (OR) = 2.57 [1.02-6.64]; p = 0.049] and alcohol abuse (OR = 2.68 [1.27-5.69]; p = 0.01).
  
  
  
  Our findings suggest that NSAIDs, often taken by young and healthy patients, may worsen the course of CAP with delayed therapy and a higher rate of pleuropulmonary complications.
authors.affiliation: Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France. basille.damien@chu-amiens.fr.|Recif Unit, University Hospital Amiens, Amiens, France. basille.damien@chu-amiens.fr.
authors.forename: Damien
authors.identifier: 0000-0001-8979-9792
authors.initials: D
authors.lastname: Basille
authors.affiliation: Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Plouvier
authors.affiliation: Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Trouve
authors.affiliation: Recif Unit, University Hospital Amiens, Amiens, France.|Internal Medicine, University Hospital Amiens, Amiens, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Duhaut
authors.affiliation: Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France.|Recif Unit, University Hospital Amiens, Amiens, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Andrejak
authors.affiliation: Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Jounieaux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008169:Lung Abscess / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010996:Pleural Effusion / Q000209:etiology*; D011014:Pneumonia / Q000150:complications* / Q000188:drug therapy; D011446:Prospective Studies; D012307:Risk Factors; D061665:Time-to-Treatment
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Community-acquired pneumonia; Empyema; Lung abscess; Non-steroidal anti-inflammatory drug; Parapneumonic effusion