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Benzodiazepine Use & Risk of Pneumonia

CHEST; 2018 Jan; Chen, Winkelman, et al

Publish date:: January 16, 2018

There is a dose-response relationship between current benzodiazepine receptor agonist (BZRA) use and the risk of hospitalization for pneumonia, a recent study suggests. The population-based nested case-control study conducted between 2002 and 2012 included new BZRA users who did not have any BZRA prescriptions in the preceding 2 years and identified 12,002 individuals hospitalized for pneumonia and 12,002 disease risk score-matched control subjects. Researchers found:

Current BZRA exposure was associated with hospitalization for pneumonia (adjusted OR [aOR], 1.86).
Benzodiazepine hypnotic agents (aOR, 2.42) had a higher risk of pneumonia than did benzodiazepine anxiolytic agents (aOR, 1.53) or nonbenzodiazepine hypnotic agents (aOR, 1.60).
Midazolam had a higher risk (aOR, 5.77) of hospitalizations for pneumonia than other individual BZRAs.

Citation:

Chen T, Winkelman JW, Mao W, et al. The use of benzodiazepine receptor agonists and the risk of hospitalization for pneumonia. A nationwide population-based nested case-control study. CHEST. 2017;153:161-171. doi:10.1016/j.chest.2017.07.030.

Commentary:

Benzodiazepine use, particularly when used as a sleep aid, has many adverse effects and this study adds another potential adverse effect to the list. Psychotropic and hypnotic drugs can impair cognitive and psychomotor abilities. In fact, a 2013 study suggested an increase in motor vehicle accidents in individuals who were taking benzodiazepines or other sleep enhancing medications such as zolpidem.¹ Remember, due to excess daytime sedation, the FDA in 2013 lowered the recommended dose of zolpidem due to excessive daytime sleepiness.² The current study gives another reason to think twice before prescribing benzodiazepines to aid with sleeping. — Neil Skolnik, MD

Chang CM, Wu EC, Chen CY, et al. Br J Clin Pharmacol. 2013;75(4):1125-33. doi:10.1111/j.1365-2125.2012.04410.x.
US Food and Drug Administration. FDA Safety Announcement. Risk of next-morning impairment after use of insomnia drugs; FDA requires lower recommended doses for certain drugs containing zolpidem (Ambien, Ambien CR, Edluar, and Zolpimist). January 10, 2013. http://www.fda.gov/downloads/Drugs/DrugSafety/UCM335007.pdf. Accessed January 10, 2018.

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