ICAAC 2012: Are Statins Beneficial for Patients with Candida Fungal Infections?

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Use of statin drugs to manage elevated cholesterol in people at risk for cardiovascular disease may also reduce short-term mortality among people with Candida fungal infections, perhaps due to their immunomodulatory properties,according to a study presented at the 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2012) this week in San Francisco.

This retrospective cohort study looked at more than 400 patients hospitalized with candidemia (Candida bloodstream infection), 14% of whom were taking statins. Despite people on statins having more comorbid health conditions, and statin and non-statin patients receiving equivalent antifungal treatment, those taking statins had a significantly lower fatality rate at 5 days (5% vs 7%, respectively). However, the 2 groups had similar rates of Candida persistence, stability at 48 hours, and mortality at 30 days.

Below is an edited excerpt from an ICAAC media advisory describing the study findings in more detail.

Drugs for Cholesterol Control Could Provide Benefits in Patients with Candidemia

Candidemia is a major cause of complications and death in hospitalized patients. It has been suggested that the use of hydroxymethylglutaryl-CoA reductase inhibitors, also known as statins, the drug of choice to treat dyslipidemia, may have a beneficial effect on outcomes of patients with infection. Statins possesses anti-inflammatory, anticoagulant, and anti-oxidative properties that are thought to have beneficial effects during sepsis. Furthermore, statins exhibit intrinsic activity against Candida species.

A multidisciplinary team leading by Professor Cuervo and including infectious diseases physicians and microbiologist from six hospitals in Spain, Brazil, and Argentina has performed a research dealing with the hypothesis that statins improve the outcomes of adult patients with candidemia.  The results of the current study will be presented at the 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy 2012 meeting in San Francisco on September 9.

Cuervo et al. demonstrated that patients on statin therapy were older and more frequently had cardiovascular chronic illness. Candida albicans was the most common species followed by C. parapsilosis, C. tropicalis, C. glabrata, and C. krusei. Despite patients received similar antifungal treatment and had equivalent severity of disease, those on statin therapy had lower early (5 day) case fatality rate. This effect was not observed with other cardiovascular drugs (aspirin, beta blockers, and ACE inhibitors). Overall (30 day) case fatality rate was similar between groups. The results were equivalent when more severely immunosuppressed patients, those with neutropenia, were excluded.

These results suggest that the use of statins may have a beneficial effect on outcomes of patients with candidemia. This hypothesis deserves to be evaluated in prospective studies.

9/14/12

Reference

G Cuervo, C Garcia-Vidal, M Nucci, et al. Effect of Statin Use on the Outcomes of Adults with Candidemia. 52nd Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC 2012). San Francisco. September 9-12, 2012. Abstract M-329.

Other Source

ICAAC/American Society for Microbiology. Drugs for Cholesterol Control Could Provide Benefits in Patients with Candidemia. Press release. September 9, 2012.