, Volume 32, Issue 5, p 795
Date: 21 Mar 2006

Statins for sepsis: a cautionary note

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There is a growing body of evidence that prior statin therapy lowers the incidence, severity and mortality of sepsis. A recent cohort analysis of 69,168 patients demonstrated reductions of broadly 20–25% [1], suggesting that patients with major infections should continue statin therapy. In their editorial in this journal Mekontso-Dessap and Brun-Buisson [2] go further in speculating that statins should be investigated as adjuvant therapy for established sepsis (as opposed to a role in primary prevention). Whilst not wishing to discourage such investigations, we have concerns regarding statin use in the critically ill relating to their known neuromuscular toxicity potentially facilitating the development of critical illness weakness syndrome.

Although statins rarely cause rhabdomyolysis, their neuromuscular adverse effects are not restricted to this presentation and include an axonal neuropathy as well as myalgia and weakness with or without a rise in creatine kinase [3]. The incidence o ...