The Effect of Statins on the Risk of Recurrent Clostridium difficile Infection

Abstract

Introduction: To assess the effect of statins on recurrent Clostridium difficile infection (RCDI) among hospitalized patients. Methods: An IRB-approved retrospective case control study in which 2,020 patients were admitted for >48 hours in our institution between January 2007 and November 2013 with CDI, and had adequate follow-up. CDI was defined as >3 episodes of loose stools in <24 hours with a positive CD stool toxin assay. RCDI was defined as readmission for recurrent diarrhea with second positive stool test 15 days following complete resolution of previous diarrheal episode and cessation of CDI treatment. Computerized medical records to investigate demographics, laboratory blood work, Carlson comorbidity index, and medication used. Patients were divided statins group (patients using statins) and control group. Statin exposure was defined as a history of statin use for at least one year prior to developing CD. Statins considered include simvastatin, atorvastatin, pravastatin, lovastatin, fluvastatin, and rosuvastatin. Univariate predictors of CD and multiple logistic regression was used to assess whether statins use had impact on RCDI, controlling for age, serum albumin, modified Carlson comorbidity index (CCI), PPI, antibiotics, and CDI treatment. Results: Two thousand twenty patients had been identified; in statins group 122 out of 674 patients (18.1%) had RCDI. In the control group 242 out of 1345 patients (17.9%) had RCDI. Statins did not have any impact on RCDI in univariate or in multivariate model (Table 1). Conclusion: Contrary to the previous reports, our study did not show any protective effect of statin on RCDI.Table 1: Multiple Logistic Regressions and Risk Factors for RCDITable 2: Demographic and Clinical Characteristics of the Study Population