Statin use and the risk of Clostridium difficile in academic medical centres
Gut,  Clinical Article

Motzkus–Feagans CA et al. – The data were consistent with a growing body of literature demonstrating a reduced risk of infections with statin use. Statins' pleiotropic properties may provide protection against C difficile infection.

Methods
  • Patients over 18 years of age admitted to hospitals contributing data to the University HealthSystem Consortium between 2002 and 2009 were eligible.
  • Patients with the ICD–9–CM code 008.45 who received a minimum 3–day course of either metronidazole or oral vancomycin on/after day 5 of admission were considered incident cases of C difficile infection.
  • 31472 incident cases of C difficile infection were identified and matched to five controls, on hospital, year/quarter of admission date, and age ±10 years (N=78096).
  • Patients who were administered one drug in the statin class (atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin or simvastatin) before the index date were considered to be exposed.
  • Conditional logistic regression modelling provided adjusted odds ratios and 95% CI.

Results
  • Compared with non–users, users of any drug within the statin class were 0.78 times less likely to develop C difficile infection in the hospital (95% CI 0.75 to 0.81) adjusting for potential confounders.
  • Differences in estimates for specific statins were minimal.
  • Niacin, fibrates and selective cholesterol absorption inhibitors showed no association with the risk of C difficile infection.

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