Abstract
In 1980 and 1982 two case reports documented reactivation of pulmonary tuberculosis in patients who had used nonsteroidal anti-inflammatory drugs (NSAIDs). A case-control study was designed to test the hypothesis that such an association does exist. Data for 38 patients were obtained from the patients' family physicians, and each patient was matched with a control from the same practice for age, sex, race and length of time in that practice. A statistically significant relation was found between the reactivation of tuberculosis and the use of NSAIDs. However, further research is imperative to determine whether the association is direct, indirect or secondary to an unknown factor. Physicians should keep in mind that NSAIDs are potent anti-inflammatory agents and may thus activate, spread and mask infections.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Block S. H. Indomethacin and occult infections. JAMA. 1979 Jun 29;241(26):2786–2786. [PubMed] [Google Scholar]
- Brennan M. Activation of latent tuberculosis by nonsteroidal anti-inflammatory agents. Can Med Assoc J. 1980 Feb 23;122(4):400–402. [PMC free article] [PubMed] [Google Scholar]
- Collins F. M. The immunology of tuberculosis. Am Rev Respir Dis. 1982 Mar;125(3 Pt 2):42–49. doi: 10.1164/arrd.1982.125.3P2.42. [DOI] [PubMed] [Google Scholar]
- Holmes P. W., Norton L. S., McConchie I., Shanahan E. A. Naproxen-aspirin combination in suppression of the inflammatory response to an empyema. Med J Aust. 1981 Apr 4;1(7):341–367. doi: 10.5694/j.1326-5377.1981.tb135625.x. [DOI] [PubMed] [Google Scholar]
- Jacobs J. S. Sudden death in arthritic children receiving large doses of indomethacin. JAMA. 1967 Mar 20;199(12):932–934. [PubMed] [Google Scholar]
- Koppanyi T., Avery M. A. Species differences and the clinical trial of new drugs: a review. Clin Pharmacol Ther. 1966 Mar-Apr;7(2):250–270. doi: 10.1002/cpt196672250. [DOI] [PubMed] [Google Scholar]
- MACKINNON J. Tuberculosis occurring during steroid therapy. Br Med J. 1959 Dec 19;2(5163):1375–1378. doi: 10.1136/bmj.2.5163.1375. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MAYFIELD R. B. Tuberculosis occurring in association with corticosteroid treatment. Tubercle. 1962 Mar;43:55–60. doi: 10.1016/s0041-3879(62)80048-8. [DOI] [PubMed] [Google Scholar]
- Robinson H. J., Phares H. F., Graessle O. E. Effects of indomethacin on acute, subacute, and latent infections in mice and rats. J Bacteriol. 1968 Jul;96(1):6–13. doi: 10.1128/jb.96.1.6-13.1968. [DOI] [PMC free article] [PubMed] [Google Scholar]
- STEAD W. W. THE PATHOGENESIS OF PULMONARY TUBERCULOSIS AMONG OLDER PERSONS. Am Rev Respir Dis. 1965 Jun;91:811–822. doi: 10.1164/arrd.1965.91.6.811. [DOI] [PubMed] [Google Scholar]
- STEAD W. W. THE PATHOGENESIS OF PULMONARY TUBERCULOSIS AMONG OLDER PERSONS. Am Rev Respir Dis. 1965 Jun;91:811–822. doi: 10.1164/arrd.1965.91.6.811. [DOI] [PubMed] [Google Scholar]
- Sackett D. L. Bias in analytic research. J Chronic Dis. 1979;32(1-2):51–63. doi: 10.1016/0021-9681(79)90012-2. [DOI] [PubMed] [Google Scholar]
- Short B. L., Miller M. K., Fletcher J. R. Improved survival in the suckling rat model of group B streptococcal sepsis after treatment with nonsteroidal anti-inflammatory drugs. Pediatrics. 1982 Sep;70(3):343–347. [PubMed] [Google Scholar]
- Simon L. S., Mills J. A. Drug therapy: nonsteroidal antiinflammatory drugs (first of two parts). N Engl J Med. 1980 May 22;302(21):1179–1185. doi: 10.1056/NEJM198005223022105. [DOI] [PubMed] [Google Scholar]
- Solomon L. Activation of latent infection by indomethacin: a report of three cases. Br Med J. 1966 Apr 16;1(5493):961–962. doi: 10.1136/bmj.1.5493.961. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vivaldi E. Effect of chronic administration of analgesics on resistance to experimental infection of the urinary tract in rats. Nephron. 1968;5(3):202–209. doi: 10.1159/000179630. [DOI] [PubMed] [Google Scholar]