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

S. W. Park, A. R. Choi, H. J. Lee, H. Chung, J. C. Park, S. K. Shin, S. K. Lee, Y. C. Lee, J. E. Kim, H. Lee

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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.

Original languageEnglish
Pages (from-to)619-627
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume38
Issue number6
DOIs
Publication statusPublished - 2013 Sep 1

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Clostridium Infections
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Clostridium difficile
Proton Pump Inhibitors
Therapeutics
Multivariate Analysis
Metronidazole
Pharmaceutical Preparations
Endoscopy
Medical Records
Diarrhea
Recurrence

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

Cite this

Park, S. W. ; Choi, A. R. ; Lee, H. J. ; Chung, H. ; Park, J. C. ; Shin, S. K. ; Lee, S. K. ; Lee, Y. C. ; Kim, J. E. ; Lee, H. / The effects of statins on the clinical outcomes of Clostridium difficile infection in hospitalised patients. In: Alimentary Pharmacology and Therapeutics. 2013 ; Vol. 38, No. 6. pp. 619-627.
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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.",
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The effects of statins on the clinical outcomes of Clostridium difficile infection in hospitalised patients. / Park, S. W.; Choi, A. R.; Lee, H. J.; Chung, H.; Park, J. C.; Shin, S. K.; Lee, S. K.; Lee, Y. C.; Kim, J. E.; Lee, H.

In: Alimentary Pharmacology and Therapeutics, Vol. 38, No. 6, 01.09.2013, p. 619-627.

Research output: Contribution to journalArticle

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T1 - The effects of statins on the clinical outcomes of Clostridium difficile infection in hospitalised patients

AU - Park, S. W.

AU - Choi, A. R.

AU - Lee, H. J.

AU - Chung, H.

AU - Park, J. C.

AU - Shin, S. K.

AU - Lee, S. K.

AU - Lee, Y. C.

AU - Kim, J. E.

AU - Lee, H.

PY - 2013/9/1

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N2 - 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.

AB - 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.

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