Statins and Sepsis Literature Review

DOI: 10.4236/pp.2013.48082   PDF   HTML     4,278 Downloads   6,205 Views  


Recent data suggest that, in addition to improving dyslipidemia, statin may reduce the risk of infections and infection-related complications. The aim of this study is to make a review of the literature about the effects of statins on clinically relevant outcomes of patients admitted to the hospital and having an infection and/or sepsis, principally in terms of intensive care unit admissions and related death.

Share and Cite:

A. Torres, A. Cascales, P. Alarcón, A. López Ruiz, M. Gil and M. Gil, "Statins and Sepsis Literature Review," Pharmacology & Pharmacy, Vol. 4 No. 8, 2013, pp. 573-577. doi: 10.4236/pp.2013.48082.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] J. C. Marshall, “Sepsis: Current Status, Future Prospects,” Current Opinion in Critical Care, Vol. 10, No. 4, 2004, pp. 250-264.
[2] M. Terblanche, Y. Almog, R. S. Ronsenson, T. S. Smith and D. G. Hackam, “Statin: Panacea for Sepsis?” Lancet Infectious Diseases, Vol. 6, No. 4, 2006, pp. 242-248.
[3] I. M. Tleyjeh, T. Kashour, F. A. Hakim and V. A. Zimmerman, P. J. Erwin, et al., “Statins for the Prevention and Treatment of Infections. A Systematic Review and Meta-Analysis,” Archives of Internal Medicine, Vol. 169, No. 18, 2009, pp. 1658-1667.
[4] I. Kouroumichakis, N. Papanas, S. Proikaki, P. Zarogoulidis and E. Maltezos, “Statins in Prevention and Treatment of Severe Sepsis and Septic Shock,” European Journal of Internal Medicine, Vol. 22, No. 2, 2011, pp. 125-133.
[5] G. Weitz-Schmidt, “Statins as Anti-Inflammatory Agents,” Trends in Pharmacological Sciences, Vol. 23, No. 10, 2002, pp. 482-486.
[6] L. M. Blanco-Colio, J. Tunon, J. L. Martin-Ventura and J. Egido, “Antiinflammatory and Inmunomoduladory Effects of Statins,” Kidney International, Vol. 63, 2003, pp. 12-23.
[7] M. Terblanche, Y. Almog, R. S. Rosenson, T. S. Smith and D. G. Hackman, “Statins and Sepsis: Multiple Modifications at Multiple Levels,” Lancet Infectious Diseases, Vol. 7, No. 5, 2007, pp. 358-368.
[8] C. P. Martin, R. L. Talbert, D. S. Burgess and J. I. Peters, “Effectiveness of Statins in Reducing the Rate of Severe Sepsis: A Retrospective Evaluation,” Pharmacotherapy, Vol. 27, No. 1, 2007, pp. 20-26.
[9] B. Zingarelli, “Nuclear Factor-Kappa B,” Critical Care Medicine, Vol. 33, No. 12, 2005, pp. s414-s416.
[10] M. E. Falagas, C. G. Makris, D. K. Mstthaiou and P. I. Rafailidis, “Statins for Infection and Sepsis: A Systematic Review of the Clinical Evidence,” Journal of Antimicrobial Chemotherapy, Vol. 61, No. 4, 2008, pp. 774-785.
[11] L. Kronmann, C. Hatfield and K. Kronmann, “Statin Therapy: Not Just Used to Lower Cholesterol?” Critical Care Nurse, Vol. 30, No. 2, 2007, pp. 154-160.
[12] S. Steiner, W. S. Speidl, J. Pleiner, et al., “Simvastatin Blunts Endotoxin-Induced Tissue Factor in Vivo,” Circulation, Vol. 111, No. 14, 2005, pp. 1841-1846.
[13] G. Del Real, S. Jiménez-Baranda, E. Mira, et al., “Statins Inhibit HIV Infection by Down-Regulating Rho Activity,” Journal of Experimental Medicine, Vol. 200, No. 4, 2004, pp. 541-547.
[14] M. W. Merx, E. A. Liehn, U. Janssens, et al., “HMG-CoA Reductase Inhibitor Simvastatin Profoundly Improves Survival in a Murine Modelo Os Sepsis,” Circulation, Vol. 109, No. 21, 2004, pp. 2560-2565.
[15] A. Gyetvai, T. Emri, K. Takács, et al., “Lovastatin Posesses a Fungistatic Effect against Candida albicans, but Does Not Trigger Apoptosis in This Opportunistic Human Patogen,” FEMS Yeast Research, Vol. 6, No. 8, 2006, pp. 1140-1148.
[16] V. Novack, M. Eisinger, A. Frenkel, M. Terblanche, N. K. Adhikari, et al., “The Effects of Statins Therapy on Inflammatory Cytokines in Patients with Bacterial Infections: A Randomized Double-Blind Placebo Controlled Clinical Trial,” Intensive Care Medicine, Vol. 35, No. 7, 2009, pp. 1255-1260.
[17] K. L. Calisto, B. de Melo Carvalho, E. R. Ropelle, F. C. Mittestainer, A. C. A. Camacho, et al., “Atorvastatin Improves Survival in Septic Rats: Effect on Tissue Inflammatory Pathway and on Insulina Signaling,” PloS One, Vol. 5, No. 12, 2010, Article ID: e14232.
[18] I. G. Macreadi, G. Johnson, T. Schlosser and P. I. Macreadi, “Growth Inhibition of Candida Species and Aspergillus fumigatus by Statins,” FEMS Microbiology Letters, Vol. 262, No. 1, 2006, pp. 9-13.
[19] C. Westermeyer and I. G. Macreadi, “Simvastatin Reduces Ergosterol Levels, Inhibits Growth and Causes Loss of mtDNA in Candida glabrata,” FEMS Yeast Research, Vol. 7, No. 3, 2007, pp. 436-441.
[20] R. W. Thomsen, A. Riss, J. B. Kornum, S. Christensen, S. P. Johnsen, et al., “Preadmission Use of Statins and Outcomes after Hospitalization with Pneumonia,” Archives of Internal Medicine, Vol. 168, No. 19, 2008, pp. 2081-2087.
[21] G. Mells and J. Neuberger, “Reducing the Risks of Cardiovascular Disease in Liver Allograft Recipients,” Transplantation, Vol. 83, No. 9, 2007, pp. 1141-1150.
[22] A. P. Liappis, V. L. Kan, C. G. Rochester and G. L. Simon, “The Effect of Statins on Mortality in Patients with Bacteremia,” Clinical Infectious Diseases, Vol. 33, No. 8, 2001, pp. 1352-1357.
[23] Y. Almog, A. Shefer, V. Novack, N. Maimon, L. Barski, et al., “Prior Statin Therapy Is Associated with a Decreased Rate of Severe Sepsis,” Circulation, Vol. 110, 2004, pp. 880-885.
[24] R. Gupta, L. C. Plantinga, N. E. Fink, M. L. Melamed, J. Coresh, et al., “Statin Use and Hospitalization for Sepsis in Patients with Chronic Kidney Disease,” JAMA, Vol. 297, No. 13, 2007, pp. 1455-1464.
[25] E. M. Van De Garde, E. Hak, P. C. Souverein, A. W. Hoes, J. M. van den Bosch and H. G. Leufkens, “Statin Treatment and Reduced Risk of Pneumonia in Patients with Diabetes.”
[26] P. Kruger, K. Fitzsimmons, D. Cook, M. Jones and G. Nimmo, “Statin Therapy Is Associated with Feder Deaths in Patients with Bacteraemia,” Intensive Care Medicine, Vol. 32, No. 1, 2006, pp. 75-79.
[27] D. G. Hackam, M. Mandami, P. Li and D. A. Redelmeier, “Statins and Sepsis in Patients with Cardiovascular Disease: A Population-Based Cohort Analysis,” Lancet, Vol. 367, No. 9508, 2006, pp. 413-418.
[28] Y. Almog, V. Novack, M. Eisinger, A. Porath, L. Novack, et al., “The Effect of Statin Therapy on Infection-Related Mortality in Patients with Atherosclerotic Diseases,” Critical Care Medicine, Vol. 35, No. 2, 2007, pp. 372-378.
[29] C. P. Martin, R. L. Talbert, D. S. Burgess and J. I. Peters, “Effectiveness of Statins in Reducing the Rate of Severe Sepsis: A Retrospective Evaluation,” Pharmacotherapy, Vol. 27, No. 1, 2007, pp. 20-26.
[30] P. Kruger, K. Fitzsimmons, D. Cook, M. Jones and G. Nimmo, “Statin Therapy Is Associated with Fewer Deaths in Patients with Bacteraemia,” Intensive Care Medicine, Vol. 32, No. 1, 2006, pp. 75-79.
[31] E. M. Mortensen, M. I. Restrepo, A. Anzueto and J. Pugh, “The Effect of Prior Statin Use on 30-Day Mortality for Patients Hospitalized with Community-Acquired Pneumonia,” Respiratory Research, Vol. 6, 2005, p. 82.
[32] H. Schmidt, R. Hennen, A. Keller, et al., “Association of Statin Therapy and Increased Survival in Patients with Multiple Organ Dysfunction Syndrome,” Intensive Care Medicine, Vol. 32, No. 8, 2006, pp. 1248-1251.
[33] S. Al Harbi, H. M. Tamim and Y. N. Marabi, “Association between Statin Therapy and Outcomes in Critically Ill Patients: A Nested Cohorte Study,” BMC Clinical Pharmacology, Vol. 11, 2011, p. 12.
[34] F. J. Frost, H. Petersen, K. Tollestrup and B. Skipper, “Influenza and COPD Mortality Protection as Pleiotropic, Dose-Dependent Effects of Statins,” Chest, Vol. 131, No. 4, 2007, pp. 1006-1012.
[35] R. G. Schielenger, D. S. Fedson, S. S. Jick, H. Jick and C. R. Meier, “Statins and the Risk of Pneumonia: A Population-Based, Nested Case-Control Study,” Pharmacotherapy, Vol. 27, No. 3, 2007, pp. 325-332.
[36] D. Viasus, D. Gudiol, N. Fernández-Sabé, I. Cabello, G. García-Vidal, et al., “Effect of Statins on Outcomes in Inmunosuppressed Patients with Bloodstream Infections,” European Journal of Clinical Microbiology & Infectious Diseases, Vol. 30, No. 1, 2011, pp. 77-82.
[37] R. Fernandez, V. J. De Pedro and A. Artigas, “Statin Therapy Prior to ICU Admisión: Protection against Infection or a Severity Marker?” Intensive Care Medicine, Vol. 32, No. 1, 2006, pp. 160-164.
[38] K. C. Yang, J. Y. Chien, W. K. Tseng, P. R. Hsueh, C. J. Yu and C. C. Wu, “Statins Do Not Improve Short-Term Survival in an Oriental Population with Sepsis,” American Journal of Emergency Medicine, Vol. 25, No. 5, 2007, pp. 494-501.
[39] P. Kopterides, M. E. Falagas, “Statins for Sepsis: A Critical and Updated Review,” Clinical Microbiology and Infection, Vol. 15, No. 4, 2009, pp. 325-334.
[40] G. N. Forrest, A. M. Kopack and E. N. Perencevich, “Statins in Candidemia: Clinical Outcomes from a Matched Cohort Study,” BMC Infectious Diseases, Vol. 10, 2010, p. 152.
[41] H. Y. Sun and N. Singh, “Antimicrobial and Immunomodulatory Attributes of Statins: Relevante in Solid-Organ Transplant Recipients,” Clinical Infectious Diseases, Vol. 48, No. 6, 2009, pp. 745-755.
[42] K. Haldar, “Targeting the Host to Control an Infection Disorder,” Archives of Internal Medicine, Vol. 168, No. 19, 2008, pp. 2067-2068.
[43] P. S. Kruger, N. M. Freir, B. Venkatesh, T. A. Robertson, M. S. Roberts, et al., “A Preliminary Study of Atorvastatin Plasma Concentrations in Critically Ill Patients with Sepsis,” Intensive Care Medicine, Vol. 35, No. 4, 2009, pp. 717-721.
[44] S. Christensen, R. W. Thomsen, M. B. Johansen, L. Pedersen, R. Jensen, et al., “Preadmission Statin Use and One-Year Mortality among Patients in Intensive Care—A Cohorte Study,” Critical Care, Vol. 14, No. 2, 2010, p. R29.
[45] S. R. Majumdar, F. A. McAlister, D. T. Eurich, R. S. Padwal and T. J. Marrie, “Statins and Outcomes in Patients Admitted to Hospital with Community Acquired Pneumonia: Population Based Prospective Cohort Study,” BMJ, Vol. 333, 2006, p. 999.

comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.