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Researchers explain link between anti-inflammatories and C. difficile

Published on 09/01/19 at 09:53am

In the past, observational studies have found a link between the use of common nonsteroidal anti-inflammatory drugs (NSAIDs) and increased severity of the symptoms of the most common hospital-acquired infection, Clostridium difficile infection (CDI).

We are now one step closer to explaining the previously unexplained link due to new research conducted by a team of researchers at the Vanderbilt University School of Medicine who have pointed to the effects of NSAIDs in disrupting the gut microbiota, as an explanation for the connection between anti-inflammatories and C.Diff infections.

In investigating the link, the researchers turned to mouse models of antibiotic-associated CDI. The team found that while 80% of mice who hadn’t received NSAIDs survived the CDI, just 20% of those who were treated with the NSAID indomethacin survived.

The team found that the NSAID indomethacin ‘significantly’ altered the gut microbiota community structure, and this effect likely contributes to worsened symptoms of CDI.

While the results are only true to a single NSAID drug indomethacin in mice, the mechanism may apply to a broader set of NSAIDs and may be true for CDI in humans. The team called for more research into the effects of NSAIDs effects on CDI in humans and suggested that future studies may help in guiding the way we manage pain in those with CDI.

In concluding the team noted: “We believe that this unique combination of effects caused by indomethacin and CDI in the host and their microbiota could represent a generalized mechanism that leads to increased intestinal damage and complications when NSAIDs, or other drugs that alter key inflammatory molecules with pleiotropic effects, are used … Our results call for caution in the use of NSAIDs in the context of C. difficile infections but also potentially when other intestinal pathogens or insults co-occur with acute inflammatory events that affect PG balances."

Louis Goss

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