How common pain relievers may promote Clostridium difficile infections

Study findings published in mBio provide new evidence that patients treated with non-steroidal anti-inflammatory drugs (NSAIDs) are at heightened risk Clostridium difficile infections, and also offer an explanation of the underlying biological mechanism, reported ScienceDaily.

In the study, investigators followed two groups of antibiotic-treated mice for one week after infection with C. difficile. One group had been treated with the NSAID indomethacin prior to infection, and the other had not.

Only about 20 percent of the mice treated with the NSAID survived to the end of the observation period, compared to about 80 percent of the mice that hadn't been exposed to the NSAID.

Researcher David Aronoff and his collaborators determined that even brief exposure to the NSAID prior to C. difficile inoculation increased the severity of infections and shortened survival.

Further cellular and genetic analyses revealed that the NSAID exposure altered the gut microbiota and depleted the production of prostaglandins.

The researchers conclude that NSAID-driven changes worsened C. difficile infections by impairing epithelial cells, the main defense system in the intestine against infectious taxa, and by disturbing the normal immune response.