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The effects of statins on the clinical outcomes of Clostridium difficile infection in hospitalised patients

Authors
 S. W. Park ; A. R. Choi ; H. Lee ; J. E. Kim ; Y. C. Lee ; S. K. Lee ; S. K. Shin ; J. C. Park ; H. Chung ; H. J. Lee 
Citation
 Alimentary Pharmacology and Therapeutics, Vol.38(6) : 619~627, 2013 
Journal Title
 Alimentary Pharmacology and Therapeutics 
ISSN
 0269-2813 
Issue Date
2013
Abstract
BACKGROUND: An association between exposure to statin drugs and favourable treatment outcomes for various types of infections has been established. AIM: To determine the clinical characteristics and treatment outcomes of Clostridium difficile infection (CDI) among hospitalised patients taking statin drugs. METHODS: The medical records were reviewed for consecutive in-patients with CDI confirmed by positive toxin assay (A or B), C. difficile culture, or the presence of pseudomembrane on endoscopy. Treatment success was defined as the resolution of diarrhoea within 6 days of therapy. The primary end points were assessed by average symptom recovery time and treatment response (success or failure). RESULTS: Among 949 patients, the overall response to metronidazole was 91.9%. The baseline characteristics showed some differences between statin users and statin non-users with respect to mean disease severity score. In the multivariate analysis, successful treatment response was significantly associated with the absence of exposure to proton pump inhibitors (PPIs) (OR = 0.690, 95% CI = 0.513-0.929, P = 0.014) and with exposure to statins (OR = 1.449, 95% CI = 1.015-2.070, P = 0.041). Contrary to the treatment response, univariate and multivariate analyses failed to show that exposure to PPIs or statins affected symptom recovery times. Sixty-day CDI recurrence rates for those patients with statin exposure were significantly lower compared with those patients without statin exposure (3% vs. 7.3%, respectively; RR = 0.393, 95% CI = 0.167-0.926, P = 0.033). CONCLUSION: Prior statin exposure in patients with C. difficile infection is associated with a successful response to treatment.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87572
DOI
10.1111/apt.12439
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Medical Research Center
1. 연구논문 > 1. College of Medicine > Dept. of Orthopedic Surgery
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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Link
 http://onlinelibrary.wiley.com/doi/10.1111/apt.12439/abstract
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