Abstract
PurposeA previous meta‐analysis of randomized trials did not confirm findings from observational studies that suggested that statins reduce the risk of infection. However, animal experiments indicate that statins may be more effective in reducing the risk and/or the severity of infection among patients with diabetes. Hence, we evaluated the effect of statins on antibiotic prescriptions (a proxy for infections) among patients with drug‐treated type 2 diabetes using two confounding‐reducing observational designs.MethodsWe conducted a prescription sequence symmetry analysis and a cohort study using the IADB.nl pharmacy prescription database. For the prescription sequence symmetry analysis, a sequence ratio was calculated. The matched cohort study, comparing the time to first antibiotic prescription between periods that statins are initiated and non‐use periods, was analyzed using stratified Cox regression.ResultsPrescription sequence symmetry analysis of 4684 patients with drug‐treated type 2 diabetes resulted in an adjusted sequence ratio of 0.86 (95% confidence interval [CI]: 0.81 to 0.91). Corresponding figures for the cohort analysis comparing 9852 statin‐initiation with 4928 non‐use periods showed similar results (adjusted hazard ratio: 0.88, 95%CI: 0.83 to 0.95).ConclusionsThese findings suggest that statins are associated with a reduced risk of infections among patients with drug‐treated type 2 diabetes. © 2016 The Authors. Pharmacoepidemiology and Drug Safety Published by John Wiley & Sons Ltd.
Highlights
Evidence from several observational studies suggest that statins reduce the severity and risk of various infections, including sepsis, pneumonia, hospital-acquired infections, community-acquired infections, influenza, bacteremia, and urinary tract infections.[1,2,3,4] a meta-analysis of data from large randomized statin trials did not show a reduced risk of infections among the treated group.[5]
Of all incident statin users, 2513 patients received their first antibiotic prescription before starting statin therapy and 2132 patients started their antibiotic course after initiating statin therapy
Statin initiation was associated with a decreased risk of receiving antibiotic prescriptions among patients with drug-treated type 2 diabetes
Summary
Evidence from several observational studies suggest that statins reduce the severity and risk of various infections, including sepsis, pneumonia, hospital-acquired infections, community-acquired infections, influenza, bacteremia, and urinary tract infections.[1,2,3,4] a meta-analysis of data from large randomized statin trials did not show a reduced risk of infections among the treated group.[5]. All of the randomized trials included in the meta-analysis were primarily designed to evaluate the effect of statins on cardiovascular. Statins are known to reduce the amount of membrane-associated or activated Rac[1,13,14,15] a Rho GTPase involved in bacterial invasion.[16,17,18,19] This activity against Rac[1] may explain the observation in pre-clinical studies that statins reduce bacterial invasion.[20,21] Several studies indicate that diabetes is associated with increased Rac[1] activation,[22,23] suggesting that statins should be effective among patients with diabetes. The potentially smaller benefits may be outweighed by the increased risk of incident diabetes among patients using statins.[24]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
