title: The effects of statins on the clinical outcomes of Clostridium difficile infection in hospitalised patients.
abstract: BACKGROUND
  An association between exposure to statin drugs and favourable treatment outcomes for various types of infections has been established.
  
  
  OBJECTIVE
  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).
  
  
  CONCLUSIONS
  Prior statin exposure in patients with C. difficile infection is associated with a successful response to treatment.
authors.affiliation: Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: S W
authors.initials: SW
authors.lastname: Park
authors.forename: A R
authors.initials: AR
authors.lastname: Choi
authors.forename: H J
authors.initials: HJ
authors.lastname: Lee
authors.forename: H
authors.initials: H
authors.lastname: Chung
authors.forename: J C
authors.initials: JC
authors.lastname: Park
authors.forename: S K
authors.initials: SK
authors.lastname: Shin
authors.forename: S K
authors.initials: SK
authors.lastname: Lee
authors.forename: Y C
authors.initials: YC
authors.lastname: Lee
authors.forename: J E
authors.initials: JE
authors.lastname: Kim
authors.forename: H
authors.initials: H
authors.lastname: Lee
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003967:Diarrhea / Q000188:drug therapy / Q000209:etiology; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D054328:Proton Pump Inhibitors; D008795:Metronidazole