Drug-drug interactions between statins and antibiotics: A systematic review and meta-analysis of observational studies.

In 30 seconds

This systematic review and meta-analysis assessed observational evidence on muscle toxicity when statins are used with interacting antibiotics, compared with statin therapy alone. Three studies met the inclusion criteria. Concurrent use was associated with higher odds of statin-associated myopathy or rhabdomyolysis: pooled OR 2.13 (95% CI 1.82-2.50). A leave-one-out sensitivity analysis found that the pooled estimate did not change when individual studies were excluded. The findings indicate an association, not proof that antibiotic co-use causes muscle toxicity.

Key findings

• Across three observational studies, concurrent statin and interacting antibiotic use was associated with higher odds of muscle toxicity: pooled OR 2.13 (95% CI 1.82-2.50).
• The pooled estimate did not change when individual studies were excluded in leave-one-out sensitivity analysis.

Why it matters

The findings highlight a potential safety concern when prescribing interacting antibiotics to people taking statins, particularly because the outcomes include myopathy and rhabdomyolysis. The pooled estimate provides a quantitative summary of the observational evidence, while the limited number of included studies means the magnitude of risk across specific statins and antibiotic classes remains uncertain.

What to keep in mind

Only three observational studies met the inclusion criteria; the evidence cannot establish causation, and the authors call for larger studies to quantify risk across statins and antibiotic classes.