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Updated: Oct 3, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

Relation of antibiotic use to risk of myocardial infarction in the general population

José A Luchsinger1, Ariel Pablos-Méndez, Charles Knirsch

  • 1Division of General Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA. jal94@columbia.edu

The American Journal of Cardiology
|January 10, 2002
PubMed

Insights

Antibiotics targeting Chlamydia pneumoniae infection do not reduce the risk of myocardial infarction in the general population. This study found no protective effect of antichlamydial antibiotics on heart attack incidence.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Conflicting reports exist on the association between Chlamydia pneumoniae infection and coronary artery disease (CAD).
  • Randomized trials investigating antibiotic use for secondary CAD prevention are ongoing.
  • Physicians may consider antibiotic class choice for infection treatment in relation to CAD risk.

Purpose of the Study:

  • To determine if antibiotics with antichlamydial activity reduce myocardial infarction (MI) risk in the general population.
  • To investigate the impact of antibiotic classes on incident MI.
  • To provide evidence regarding the efficacy of antichlamydial antibiotics in cardiovascular risk reduction.

Main Methods:

  • Analysis of a healthcare claims database with 354,258 patients over a minimum 2-year period (1991-1997).
  • Proportional hazards models with time-dependent covariates were used to assess antibiotic prescription and incident MI.
  • Adjustments were made for prior CAD, age, sex, diabetes, hypertension, hyperlipidemia, and COPD.

Main Results:

  • The study observed 1,684,091 person-years and 16,139 incident MIs.
  • Adjusted hazard ratios (HR) for antibiotics with antichlamydial activity included macrolides (HR 1.10) and quinolones (HR 1.20).
  • No significant reduction in MI risk was observed with the use of antibiotics active against C. pneumoniae.

Conclusions:

  • Antibiotic use with activity against Chlamydia pneumoniae does not decrease the risk of myocardial infarction.
  • The findings suggest that targeting C. pneumoniae with antibiotics is not an effective strategy for preventing heart attacks in the general population.
  • Further research may be needed to clarify the relationship between C. pneumoniae and CAD.

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