Sa1286 The Effect of Statins on the Risk of Developing Clostridium difficile Diarrhea: A Case-Control Study

Ewelukwa, Oforbuike; Cheema, Bahar; Metzger, Sarita; Markert, Ronald J.; Akram, Salma

doi:10.1016/s0016-5085(14)60888-x

Cited by 2 publications

(8 citation statements)

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“…Thirteen of these were excluded since they did not report the outcome of interest whereas three articles were excluded due to duplication. Finally, eight studies (6 case-control studies and 2 cross-sectional studies) were included in the data analysis910111213141516. The literature review and study selection process are demonstrated in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Sensitivity analysis: Three sensitivity analyses were conducted to explore the high heterogeneity observed in this meta-analysis. First, the study by Nseir et al 12 was excluded from the meta-analysis, as it was the only study not conducted in the US (therefore, only 7 studies were included in this sensitivity analysis)9101113141516. Exclusion of this study reduced the I 2 to 84 per cent and did not significantly alter the pooled effect estimate (pooled OR 0.83; 95% CI, 0.71-0.98).…”

Section: Resultsmentioning

confidence: 99%

“…Use of statins may also decrease the risk of C. difficile infection as suggested by several epidemiologic studies910111213, although the observations are inconsistent141516. This systematic review and meta-analysis was conducted to summarize all available evidence to assess the risk of C. difficile infection among statin users versus non-users.…”

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confidence: 99%

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Statins & risk of Clostridium difficile infection

Wijarnpreecha

Panjawatanan

Ungprasert

2019

Indian Journal of Medical Research

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Background & objectives:Clostridium difficile infection is one of the most common healthcare-associated infections worldwide. Recent epidemiologic studies have suggested that statin users may have a lower risk of C. difficile infection, although the results are inconsistent. This meta-analysis was conducted with the aim of summarizing all available data to assess the risk of C. difficile infection among statin users versus non-users.Methods:A literature review was performed using the MEDLINE and EMBASE databases from inception to October 2017. Cohort, case-control and cross-sectional studies that compared the risk of C. difficile infection among statin users versus non-users were included. Pooled odds ratio (OR) and 95 per cent confidence interval (CI) were calculated using a random-effect, generic inverse variance method.Results:Six case-control studies and two cross-sectional studies met the eligibility criteria and were included in this meta-analysis. The risk of C. difficile infection among statin users was significantly lower than non-users with the pooled OR of 0.74 (95% CI, 0.61-0.89). The statistical heterogeneity of this study was high (I2=90%).Interpretation & conclusions:This meta-analysis demonstrated a decreased risk of C. difficile infection among statin users versus non-users. Further studies are required to clarify the role of statins for prevention of C. difficile infection in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Statins & risk of Clostridium difficile infection

Wijarnpreecha

Panjawatanan

Ungprasert

2019

Indian Journal of Medical Research

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“…A total of 8 studies were included in this meta-analysis, of which only 3 were abstracts; all 8 observational studies evaluated the risk of CDI with statins. 18 , 19 , 24 – 29 Two other studies that described the risk of recurrent CDI with statins were separately analyzed. 30 , 31 …”

Section: Resultsmentioning

confidence: 99%

“…Five of the 8 studies included in our meta-analysis included inpatients, 19 , 24 , 25 , 27 , 28 2 included both inpatients and outpatients, 26 , 29 and 1 study included only intensive care unit (ICU) patients. 18 The subgroup analysis of studies that included only inpatients also revealed a decreased risk of CDI with use of statins (OR 0.81; 95% CI, 0.68–0.95; P =0.01, I 2 =76%) ( Figure 6 ).…”

Section: Resultsmentioning

confidence: 99%

Statin use and the risk of <em>Clostridium difficile</em> infection: a systematic review with meta-analysis

Tariq

Mukhija

Gupta

et al. 2018

IDR

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PurposeStatins have pleiotropic effects beyond cholesterol lowering by immune modulation. The association of statins with primary Clostridium difficile infection (CDI) is unclear as studies have reported conflicting findings. We performed a systematic review and meta-analysis to evaluate the association between statin use and CDI.Patients and methodsWe searched MEDLINE, Embase, and Web of Science from January 1978 to December 2016 for studies assessing the association between statin use and CDI. The Newcastle–Ottawa Scale was used to assess the methodologic quality of included studies. Weighted summary estimates were calculated using generalized inverse variance with random-effects model.ResultsEight studies (6 case–control and 2 cohort) were included in the meta-analysis, which comprised 156,722 patients exposed to statins and 356,185 controls, with 34,849 total cases of CDI available in 7 studies. The rate of CDI in patients with statin use was 4.3%, compared with 7.8% in patients without statin use. An overall meta-analysis of 8 studies using the random-effects model demonstrated that statins may be associated with a decreased risk of CDI (maximally adjusted odds ratio [OR], 0.80; 95% CI, 0.66–0.97; P=0.02). There was significant heterogeneity among the studies, with an I2 of 79%. No publication bias was seen. Meta-analysis of studies that adjusted for confounders revealed no protective effect of statins (adjusted OR, 0.84; 95% CI, 0.70–1.01; P=0.06, I2=75%). However, a meta-analysis of only full-text studies using the random-effects model demonstrated a decreased risk of CDI with the use of statins (OR 0.77; 95% CI, 0.61–0.99; P=0.04, I2=85%).ConclusionMeta-analyses of existing studies suggest that patients prescribed a statin may be at decreased risk for CDI. The results must be interpreted with caution given the significant heterogeneity and lack of benefit on analysis of studies that adjusted for confounders.

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Sa1286 The Effect of Statins on the Risk of Developing Clostridium difficile Diarrhea: A Case-Control Study

Cited by 2 publications

References 0 publications

Statins & risk of Clostridium difficile infection

Statins & risk of Clostridium difficile infection

Statin use and the risk of <em>Clostridium difficile</em> infection: a systematic review with meta-analysis

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