The NSAID diclofenac may be linked to an “exponential” increase in the incidence of
Clostridium difficile-associated diarrhoea among primary care patients, a
UK study suggests.
Use of the drug was associated with a 35% increased risk of
C. difficile-associated disease, according to a case control study based on a national GP record database.
The study of 1,360 C. difficile-associated disease cases and 13,072 controls found that risk of the disease was linked to current diclofenac use but not to use of any other NSAID.
The increased risk with diclofenac did not appear to be dose related, but was still seen when hospitalised patients were excluded from the analysis, say the authors of the study in the
British Journal of Clinical Pharmacology.
They comment that
C. difficile-associated disease has traditionally been thought of as a nosocomial disease of mostly elderly hospitalised patients and linked to antibiotic use.
However they say cases of the disease have increasingly been reported in the community in persons who are healthy, nonhospitalised and not exposed to antibiotic treatment.
Some studies had suggested a link to NSAID use, and the current study showed that the risk appeared to be confined to diclofenc, they say.
“In patients at risk of
C. difficile-associated disease, other NSAIDs could be prescribed,” they suggested.
British Journal of Clinical Pharmacology 20102;