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GPs advised to avoid diclofenac to reduce C. difficile disease

GPs have been advised to avoid prescribing diclofenac in certain patients after a large study found the drug was linked to a higher risk of developing Clostridium difficile related disease.

In the first population-based study to assess the risk, researchers identified 1,360 cases of C. difficile associated disease occurring between 1994 and 2005 from the UK General Practice Research Database, and matched each case to 10 controls.

They found a 35% increased risk of C. difficile associated disease linked with current diclofenac use. The association was even greater in those who had been not hospitalised – with an increased risk of 43%. There was no increased risk associated with any other NSAID.

Study author Dr Paul Brassard, assistant professor in the department of medicine, McGill University Health Centre, Montreal, Canada said: ‘In patients at risk of C. difficile associated disease, other NSAIDs could be prescribed.'

British Journal of Clinical Pharmacology 2012, published online 29 January

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.2012.04191.x/abstract