Statins for community-acquired pneumonia: current state of the science.

In spite of the many advances in the diagnosis and management of community-acquired pneumonia (CAP), the mortality associated with this infection remains high. In recent years scientific evidence has emerged that shows that an excessive inflammatory response is a major cause of unfavorable outcome in patients with CAP, especially in the first few days. The use of immunomodulation appears to be an appealing option for improving prognosis in CAP. It has recently been demonstrated that statins have immunomodulatory, antioxidative and anticoagulant effects, and the beneficial effects of these drugs in sepsis have been discussed. Experimental studies have shown their effect in the modulation of the cytokine cascade and in the organization of the immunological response to respiratory infection. Most observational studies published to date support the idea that the use of statins may improve the prognosis of CAP. Randomized controlled trials are needed to validate these findings.