Impact of Statins on Cytokine Expression in Pneumonia

Inclusion Criteria:

• At least 18 years of age,
• Chart documentation by a clinician of an initial working diagnosis of pneumonia within 24 hours of admission,
• Chest x-ray or other imaging evidence consistent with pneumonia within 48 hours of hospitalization, and
• One of the following severity criteria: pneumonia severity index class III or higher, at least 2/5 components of the CURB-65, or ICU level care within 24 hours of admission.
• Having one Food and Drug Agency approved indication for statin therapy

Exclusion Criteria:

• Prior Treatment with one or more doses of a statin within 30-days prior to admission or during the current hospitalization.
• Hospitalization > 24 hours at time of the diagnosis of pneumonia.
• Hospitalization > 48 hours at time of study enrollment.
• Residence in a skilled nursing facility.
• Previously diagnosed human immunodeficiency virus infection with a current CD4 count < 200 cells/mm.
• Immunosuppression
• Patient or family decision to limit medical care ("comfort measures only").
• Known allergy to statin therapy.
• Active or planned pregnancy or breastfeeding.
• Inability to take oral medications at the time of study enrollment.
• Pre-existing liver disease or AST/ALT > 10% the upper limit of normal.
• Creatinine phosphokinase (CPK or CK) > 50% above the upper limit of normal.
• Partial ileal bypass.
• Concurrent treatment with potential interacting drugs: ketoconazole, itraconazole, amiodarone, clarithromycin, erythromycin, cyclosporine, danazol, niacin, protease inhibitors, telithromycin, verapamil, gemfiborzil, ezetimibe (Zetia), nefazodone.
• Transfer from an outside hospital.