Previous Atorvastatin Treatment and Risk of Diabetic Foot Infection in Adult Patients: A Case-control Study.

OBJECTIVE: In addition to their lipid-lowering abilities, statins have anti-inflammatory and immunomodulatory properties. Increasing recent evidence suggests the possible role of pretreatment with statins in preventing or decreasing morbidity and mortality from infection. Diabetic foot infection (DFI) is a common complication of diabetes mellitus. The aim of this study was to determine whether previous atorvastatin use is associated with reduced risk of DFI and better outcomes of these infections.

MATERIALS AND METHODS: One hundred ten adult patients admitted with a diagnosis of DFI were enrolled in the experimental group. For the control group, 123 adult patients with diabetes mellitus in an outpatient setting and without a history of DFIs were accepted. Participants in both groups were classified as statin users or non-statin users depending on history of atorvastatin treatment. For all individuals, the demographic, clinical, and laboratory findings were registered.

RESULTS: Atorvastatin was used in 49.1% of the experimental group cases and in 66.7% of the control, and it showed a statistically significant difference (P = .007). Logistic regression analysis also showed that previous atorvastatin use significantly reduces the risk of DFI (odds ratio = 0.36; 95% confidence interval, 0.19-0.71; P = .003). Severe DFI, bone involvement, and the need for surgical intervention was lower in the experimental group, but this difference was not statistically significant.

CONCLUSION: Prior therapy with atorvastatin considerably reduces the onset of DFIs. In addition to other effects, statins may be useful in preventing DFIs.