Q&A

Antibiotics ineffective for prevention of recurrent MI

J Fam Pract. 2004 July;53(7):522-530
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  • CLINICAL QUESTION: For patients who have experienced a myocardial infarction, is antibiotic therapy aimed at eradicating Chlamydia pneumoniae effective at preventing a second coronary event?
  • STUDY DESIGN: Meta-analysis (randomized controlled trials)
  • SETTING: Outpatient (any)
  • SYNOPSIS: A bacterial cause of coronary heart disease is an attractive hypothesis, since we have treatments that should be able to eliminate bacterial infection. The authors of this meta-analysis searched several databases to find English-language randomized controlled trials of antibiotic therapy directed against C pneumoniae that evaluated a clinical outcome. They found 9 studies that met their criteria, enrolling a total of more than 12,000 patients.
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BOTTOM LINE

Antibiotic therapy with a macrolide, aimed at eradicating C pneumoniae, was ineffective at reducing recurrence of a coronary event or decreasing mortality in patients who had experienced either a myocardial infarction or acute coronary syndrome. The door is closing on this intriguing hypothesis. (LOE=1a)

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