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Published on: April 17, 2021
Antibiotic therapy after acute myocardial infarction: a prospective randomized study
Ralf Zahn1, Steffen Schneider, Birgit Frilling
1Kardiologie, Herzzentrum Ludwigshafen, Germany. erzahn@aol.com
Roxithromycin treatment in acute myocardial infarction (AMI) patients did not lower mortality or morbidity. This study suggests routine macrolide antibiotic use is not recommended for AMI patients.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Chlamydia pneumoniae infection is implicated in atherosclerosis pathogenesis.
- Investigated the impact of roxithromycin on mortality and morbidity in acute myocardial infarction (AMI) patients.
Purpose of the Study:
- To determine if roxithromycin treatment reduces mortality or morbidity in patients following an acute myocardial infarction.
Main Methods:
- 872 AMI patients received either 300 mg roxithromycin or placebo daily for 6 weeks in a double-blind study.
- Primary endpoint was 12-month total mortality; secondary endpoints included combined event rates.
- Patients were randomized, with baseline characteristics and treatments well-balanced between groups.
Main Results:
- Total mortality at 12 months was similar: 6.5% for roxithromycin vs. 6.0% for placebo (P=0.739).
- No significant differences were observed in secondary combined endpoints between the roxithromycin and placebo groups.
- A higher proportion of patients in the roxithromycin group interrupted study medication (18% vs. 11%).
Conclusions:
- Roxithromycin treatment in AMI patients did not reduce 12-month event rates.
- Findings do not support the routine use of macrolide antibiotics for patients with acute myocardial infarction.
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