Drugs for cholesterol can provide benefits in patients with candidemia

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candidiasisUse of statins to manage high cholesterol in people at risk for cardiovascular disease may also reduce short-term mortality among people with fungal infections by Cândida, perhaps because of its immunomodulatory properties, according to a study presented at the 52 Inter Science Conference on antimicrobial agents and chemotherapy (ICAAC to 2012) that week in San Francisco.

This retrospective cohort study examined more than 400 patients hospitalized with candidemia (Candida infection in the bloodstream), 14% of whom were taking statins. Despite the use of statins with more comorbidities associated with health and statin status and not statin equivalent in patients receiving antifungal treatment, those taking statins had significantly lower mortality rates in 5 days (5% vs 7%, respectively ). However, the 2 groups showed similar rates of Cândida persistence, stability at 48 hours, and mortality at 30 days.

Below is an excerpt from a press office ICAAC edition describing the findings in more detail.

Candidemia is one of the leading causes of complications and death in hospitalized patients. It has been suggested that the use of hydroxymethylglutaryl-CoA reductase inhibitors, also known as statins, is the drug of choice for treating dyslipidemias, may have a beneficial effect on the outcomes of patients with infection. Statins have anti-inflammatory, anticoagulant, and antioxidant properties that are thought to have beneficial effects during sepsis. In addition, statins have intrinsic activity against certain strains of Candida.

A multidisciplinary team led by Professor Cuervo that included infectious disease and microbiology specialists from six hospitals in Spain, Brazil and Argentina has carried out a research on the hypothesis that statins could improve the outcomes of adult patients with candidemia. The results of the study will be presented at the 52 Interscience Conference on antimicrobial agents and chemotherapy up to 2012 meeting in San Francisco on 9 in September.

Cuervo et al. demonstrated that patients on statins were older and often had chronic cardiovascular diseases. Candida albicans is the most frequent species, followed by C. Parapsilosis, C. tropicalis, C. glabratae C. Krusei.

Although patients received similar antifungal treatments and whose disease severity was equivalent, those on statins had a lower early mortality rate (X XIVth day). This effect was not observed with other cardiovascular action drugs (aspirin, beta blockers, and ACE inhibitors). In general (5 days) mortality rates were similar between groups.

The results were equivalent in most severely immunosuppressed patients. Those with neutropenia were excluded. Translator's note: Neutropenia is small amount of neutrophils in the blood.

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

Translated from original 2012 ICAAC: Statins Are Beneficial for Patients with Candida Fungal Infections? by  Claudio Souza; reviewed by Mara Macedo

References

G Cuervo, C Garcia-Vidal, Nucci M, 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.

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