Povezanost uporabe psihofarmaka i recidivirajućih Clostridioides difficile infekcija

professional thesis

• Author: Katarina Šarić
• Mentor: Neven Papić (mentor)
• Committee member: Vesna Bačić Vrca (predsjednik povjerenstva)
• Committee member: Neven Papić (član povjerenstva)
• Committee member: Maja Ortner Hadžiabdić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; Zagreb
• Defense date and country: 2023-11-22, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Cilj istraživanja: Clostridioides difficile infekcije predstavljaju rastući globalni problem te
sukladno tome postoji potreba za pronalaskom novih potencijalnih pacijenata s povećanim
rizikom od infekcije. S obzirom na raširenu uporabu psihofarmaka te njihove raznovrsne
mehanizme djelovanja i učinke u gastrointestinalnom sustavu, cilj istraživanja je ispitati
povezanost upotrebe psihofarmaka i pojave recidivirajućih Clostridioides difficile infekcija.
Ispitanici i metode: Provedeno je retrospektivno kohortno istraživanje u koje su uključeni
ispitanici stariji od 60 godina, a koji su hospitalizirani u Klinici za infektivne bolesti „Dr. Fran
Mihaljević“ u Zagrebu u razdoblju od 2016. do 2019. godine radi prve epizode CDI. Kohorta
ispitanika je podijeljena u dvije skupine: bolesnici koji nisu rehospitalizirani radi rCDI unutar
tri mjeseca od otpusta i oni koji jesu hospitalizirani radi rCDI unutar tri mjeseca od prve
epizode. Prikupljeni su potrebni klinički, laboratorijski i mikrobiološki podatci o bolesnicima
iz kartona bolesnika, a psihofarmaci su u svrhu ovog istraživanja podijeljeni u šest skupina.
Rezultati: U studiju je bilo uključeno ukupno 305 ispitanika, od kojih su 180, tj., 59% žene,
prosječne dobi 78 godina (IQR (interquartile range) 71- 83 godine). Unutar cijele kohorte, 106
(34,8%) pacijenata je razvilo recidivirajuću CDI unutar 90 dana od hospitalizacije ili od
završetka terapije za prvu epizodu (ukupno je zabilježeno 171 epizoda CDI). Od navedenih
pacijenata, 76 je razvilo rCDI do 28., a 99 do 90. dana. Psihofarmake u kroničnoj terapiji
upotrebljava značajan broj pacijenata od ukupnog broja ispitanika (59,8% naspram 62,3%),
podjednako i u jednoj i u drugoj skupini. Nije utvrđena razlika u upotrebi psihofarmaka između
bolesnika koji su razvili rCDI u usporedbi s onima koji su imali samo jednu epizodu CDI.
Zaključak: Ovo istraživanje nije pronašlo statistički značajnu povezanost uporabe
psihofarmaka i recidivirajućih C. difficile infekcija, međutim, psihofarmaci su vrlo kompleksna
skupina lijekova čija je uporaba iznimno raširena, a nova saznanja o utjecaju mikrobioma na
središnji živčani sustav i obrnuto upućuju na važnost novih istraživanja.

Abstract (english)

Objectives: Clostridioides difficile infections represent a growing global problem, and
accordingly there is a need to find new potential patients with an increased risk of infection.
Considering the widespread use of psychotropic drugs and their various mechanisms of action
and effects in the gastrointestinal system, the aim of the study is to examine the connection
between the use of psychotropic drugs and the occurrence of recurrent Clostridioides difficile
infections.
Patients and Methods: A retrospective cohort study was conducted, which included subjects
over the age of 60, who were hospitalized at the Clinic for Infectious Diseases "Dr. Fran
Mihaljević" in Zagreb in the period from 2016 to 2019 for the first episode of CDI. The patient
cohort consists of patients in two groups: those who were not rehospitalized for rCDI within
three months of discharge and those who were hospitalized for rCDI within three months of the
first episode. The necessary clinical, laboratory and microbiological data on the patients were
collected from the patient records, and psychotropic drugs were divided into six groups for the
purpose of this research.
Results: A total of 305 subjects were included in the study, of which 180, i.e., 59% were
women, with an average age of 78 years (IQR (interquartile range) 71-83 years). Within the
entire cohort, 106 (34.8%) patients developed recurrent CDI within 90 days of hospitalization
or completion of therapy for the first episode (a total of 171 CDI episodes). Of these patients,
76 developed rCDI by day 28, and 99 by day 90. Psychopharmaceuticals are used in chronic
therapy by a significant number of patients out of the total number of respondents (59.8% vs.
62.3%), equally in one and the other group. No difference was found in the use of psychotropic
drugs between patients who developed rCDI compared to those who had only one episode of
CDI.
Conclusion: This research did not find a statistically significant association between the use of
psychotropic drugs and recurrent C. difficile infections, however, psychotropic drugs are a very
complex drug group whose use is extremely wide, and new knowledge about the influence of
the microbiome on the central nervous system and vice versa points to the importance of new
research.

• Keywords: Clostridioides difficile infekcije; psihofarmaci
• Keywords (english): Clostridioides difficile infections; psychopharmaceuticals
• Language: croatian
• URN:NBN: urn:nbn:hr:163:234187
• Study programme: Title: Clinical pharmacy; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/sveučilišna magistra kliničke farmacije (sveučilišni/a magistar/sveučilišna magistra kliničke farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-11 12:13:17