BMJ  2006;333:1124 (25 November), doi:10.1136/bmj.39038.505012.1F

Letters

Statins and outcomes in patients with pneumonia

Not the best combination

Majumdar et al have highlighted in their paper that the use of statins did not reduce in-hospital mortality and the need for intensive care intervention.1 Other studies, such as that reported by Mortensen et al, showed in their study that statins can lead to a reduction in mortality at 30 days in patients with community acquired pneumonia.2

In the UK British Thoracic Society (BTS) guidelines,3 the empirical antibiotics choice for hospitalised patients with severe and non-severe community acquired pneumonias includes macrolides—that is, clarithromycin or erythromycin.

The combination of macrolides and statins is not advisable and can lead to debilitating myopathy. Warnings can be seen in the British National Formulary.4 From our department's experience, patients can be left with prolonged mobility complications. Therefore, the use of statins in these patients should be carefully monitored and adjusted accordingly.

Robert Nipah, specialist registrar renal/general medicine

1 Southend University Hospital, Westcliff on Sea, Essex SS0 0RY rgnipah@hotmail.com


Competing interests: None declared.

References

  1. Majumdar SR, McAlister FA, Eurich DT, Padwal RS, Marrie TJ. Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study. BMJ 2006;333:999-1001. (11 November.)[Abstract/Free Full Text]
  2. Mortensen EM, Restrepo MI, Anzueto A, Pugh J. The effect of prior statin use on 30-day mortality for patients with community acquired pneumonia. Resp Res 2005;6:1-7.
  3. .BTS guidelines for the management of community acquired pneumonia in adults Thorax 2001;56(suppl 4).
  4. . British National Formulary 52. September 2006. Appendix 1:728.

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Relevant Article

Statins and outcomes in patients admitted to hospital with community acquired pneumonia: population based prospective cohort study
Sumit R Majumdar, Finlay A McAlister, Dean T Eurich, Raj S Padwal, and Thomas J Marrie
BMJ 2006 333: 999. [Abstract] [Full Text] [PDF]




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