Different Classes of Antibiotics Have Varying Effects on the Risk of Developing Opioid Use Disorder: A National Database Study

Objective: To examine whether different classes of antibiotics in combination with opioids differentially effect the risk of developing opioid use disorder (OUD).

Methods: A cohort study was conducted to identify adult subjects (18-65 years old) with no previous history of OUD. Two cohorts were defined: subjects who were prescribed an opioid or an opioid in combination with antibiotics in the emergency department or inpatient unit, from the years 2015 to 2018. The diagnosis of an Opioid Related Disorder (F11.10-F11.20) 12 months following discharge from the emergency department or inpatient unit was then observed within the cohorts following the index event as identified by the ICD-10 procedural coding system.

Results: Primary analysis showed that penicillin G had no statistically significant effect, while the following list of antibiotics were associated with increased risk of developing OUD in order from highest to lowest risk: cefepime > tazobactam > ertapenem > doxycycline > ceftriaxone, sulfamethoxazole > clindamycin > azithromycin > ciprofloxacin > penicillins > cefazolin > amoxicillin > penicillin V.

Conclusions: These findings suggest that the type of antibiotic prescribed in combination with opioid treatment may have important implications on the risk of developing OUD at later time points following hospital discharge.

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Work Title Different Classes of Antibiotics Have Varying Effects on the Risk of Developing Opioid Use Disorder: A National Database Study
Access
Open Access
Creators
  1. Taylor J Clegg
  2. Noor Kawmi
  3. Nicholas Graziane
Keyword
  1. Opioid use disorder
  2. Opioid
  3. Antibiotic
  4. Prescription
  5. Microbiome
  6. Emergency Department
  7. Inpatient Unit
  8. TriNetX
License In Copyright (Rights Reserved)
Work Type Article
Acknowledgments
  1. Access and support for the use of TriNetX was provided through a National Center for Advancing Translational Sciences Clinical and Translational Science Award.
Publisher
  1. Journal of Substance Use
Publication Date December 7, 2021
Publisher Identifier (DOI)
  1. https://doi.org/10.1080/14659891.2021.2010140
Deposited March 27, 2023

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Version 1
published

  • Created
  • Updated
  • Updated Acknowledgments Show Changes
    Acknowledgments
    • Access and support for the use of TriNetX was provided through a National Center for Advancing Translational Sciences Clinical and Translational Science Award.
  • Added Creator Taylor J Clegg
  • Added Creator Noor Kawmi
  • Added Creator Nicholas Graziane
  • Added 2021_clegg_kawmi_v9.pdf
  • Updated License Show Changes
    License
    • https://rightsstatements.org/page/InC/1.0/
  • Published
  • Updated Keyword, Publisher, Publisher Identifier (DOI) Show Changes
    Keyword
    • Opioid use disorder, Opioid, Antibiotic, Prescription, Microbiome, Emergency Department, Inpatient Unit, TriNetX
    Publisher
    • Journal of Substance Use
    Publisher Identifier (DOI)
    • https://doi.org/10.1080/14659891.2021.2010140
  • Updated