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Contribution of Opiate Analgesics to the Development of Infections in Advanced Cancer Patients

Shao, Yue-juan MD; Liu, Wei-shuai MD; Guan, Bing-qing MD; Hao, Jian-lei MD; Ji, Kai MD; Cheng, Xian-jiang MD; Wang, Kun MD

doi: 10.1097/AJP.0000000000000405
Original Articles

Objectives: 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.

Materials and Methods: 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.

Results: 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.

Conclusions: 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.

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

W.-s.L. and K.W. contributed equally.

Supported by the National Key Clinical Specialist Construction Programs of China (No. 2013-544), the Nature Science Foundation of China (No.81201065), and the Seed Fund for Scientific Research of Tianjin Medical University Cancer Institute and Hospital (No.1419, Tianjin, China). The authors declare no conflict of interest.

Reprints: Wei-shuai Liu, MD, or Kun Wang, MD, 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 300060, P.R. China, HuanHu-Xi Road, Ti-Yuan-Bei, He-Xi District, Tianjin 300060, P.R. China (e-mail: liuweishuai@126.com(W.-s.L.) or tjdoctorwk@163.com(K.W.)).

Received February 24, 2016

Received in revised form July 15, 2016

Accepted June 21, 2016

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