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