急性心筋梗塞後の抗生物質療法:前向きのランダム化研究
Ralf Zahn1, Steffen Schneider, Birgit Frilling
1Kardiologie, Herzzentrum Ludwigshafen, Germany. erzahn@aol.com
Circulation
|March 12, 2003
まとめ
急性心筋梗塞 (AMI) の患者のロキシトロマイシン治療は,死亡率や罹患率を低下させなかった. この研究は,常規のマクロリド抗生物質の使用は,AMI患者には推奨されないことを示唆しています.
科学分野:
- 心臓病学 心臓病学
- 感染症 感染症は感染症です.
- 薬理学 薬理学とは
背景:
- クラミジア肺炎感染症は,動脈硬化症の病原性に関与しています.
- 急性心筋梗塞 (AMI) 患者の死亡率と罹患率に対するロキシトロマイシンの影響を調査した.
研究 の 目的:
- ロキシスロマイシン治療が急性心筋梗塞後の患者の死亡率または罹患率を低減するかどうかを判断する.
主な方法:
- 872人のAMI患者は,ダブルブラインド試験で6週間にわたって毎日300mgのロキシトロミシンまたはプラセボを投与されました.
- プライマリエンドポイントは12ヶ月の総死亡率であり,二次エンドポイントは合併イベント率であった.
- 患者はランダム化され,ベースラインの特徴と治療法はグループ間でバランスが取れた.
主要な成果:
- 12ヶ月の総死亡率は,ロキシスロミシンでは6.5%,プラセボでは6.0% (P=0.739) であった.
- ロキシスロマイシンとプラセボのグループ間の二次的併合エンドポイントにおいて,有意な差異は観察されなかった.
- ロキシトロマイシン群の患者の割合が研究薬の投与を中断した (18% vs. 11%).
結論:
- AMI患者のロキシトロマイシン治療は,12ヶ月のイベント率を低下させなかった.
- 発見は,急性心筋梗塞の患者にマクロリド抗生物質の日常的な使用を支持しません.
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