More risk of C. difficile in hospitalized patients taking antidepressants

For hospitalized patients, taking trazodone, nortriptyline and mirtazapine increases their risk of contracting Clostrodioides difficile infection, a new study reveals.Year after year, in Canada, nearly 38,000 people contract this infection. In the United States, there are nearly 500,000 cases of C. difficile annually, two-thirds of which come from hospitals, long-term care facilities, or other healthcare settings.Taking antidepressants appears to explain some of these cases in hospitalized patients, according to a retrospective cohort study. Using electronic medical data from millions of hospitalized patients, American and Lebanese researchers identified 48,720 patients who had contracted C. difficile. Of this number, almost a quarter had received a prescription for antidepressants. They then selected the drugs most frequently prescribed in these patients: trazadone, nortriptyline, mirtazapine and fluoxetine.Read: Single dose of psilocybin treated major depressive disorder for six weeks, study finds It should be noted that, although commonly used, certain selective serotonin reuptake inhibitors, such as citalopram, sertraline, escitalopram and paroxetine, were excluded from the study since they represented a very small percentage of C. difficile cases.Multivariate regression analysis showed that patients taking mirtazapine were up to 2.5 times more likely to develop the infection. The odds were also higher for trazodone and nortriptyline. In the case of fluoxetine, the association was not statistically significant and therefore would not increase the chances of contracting C. difficile in hospitalized patients. In addition to antidepressants, combinations have been established with other medications, including clindamycin and beta-lactam antibiotics. Patients admitted to hospital with inflammatory bowel disease were also four times more likely to be diagnosed with C. difficile.Read: Growing evidence that influenza vaccine protects against cardiovascular diseasesCertain mechanisms have been put forward to explain this association. One of the hypotheses, described in 2020, assumes that antidepressants, by reducing the reuptake capacity of serotonin, can lead to an accumulation of this neurotransmitter in interstitial tissues and cause intestinal inflammation. Another hypothesis suggests that antidepressants deregulate the immune system and prevent the production of certain antibodies, notably gamma interferons (IFN-ã).In several countries, including Canada, cases of Clostrodioides difficile acquired in hospitals are tending to decrease, but there is an increase in prevalence in the community. Given the increasingly widespread use of antidepressants, researchers believe that more attention should be paid to the risks to which these individuals are exposed.

More risk of C. difficile in hospitalized patients taking antidepressants

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