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Literature Critique Antibiotic Trials for Coronary Heart Disease - Lab Report Example

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Literature Critique Antibiotic Trials for Coronary Heart Disease

Myocardial Infection with Chlamydia) trial performed on 302 patients with ACS
and seropositive for C. pneumoniae was conducted in USA. The patients were
randomized to placebo or azithromycin 500 mg/ day for three days followed by
500mg/ week for three months. On the basis of the results of ACADEMIC trial in
USA, Gupta etal designed a study with 60 patients in UK. These patients were
survivors of Acute Myocardial Infarction (MI) and elevated antibody titers against
Chlamydia. Another trial called STAMINA (The South Thames trial of
Antibiotics in Myocardial Infarction and unstable angina) (n=325) addressed both
C.pneumoniae and H.pylori . Multiple drug therapy using amoxicillin
(500mg/day) for H.pylori and azithromycin(500mg/day) for C.pneumoniae .
both combined with metronidazole (400 mg twice a day )and omeperazole( 20mg
twice a day )was administered to the patients. Follow up of this trial
extended for one year. There were two more large and intermediate size trials
made with randomized patient groups of ACS viz. AZACS and CLARIFY.
AZACS (Azithromycin in acute coronary syndrome) This trial involved 1450
patients in Los Angeles and this trial recruited patients regardless of their
serostatus for Chlamydia infection. treatment with azithromycin.was given for 5-
days and duration of follow up was 6-months. Another trial CLARIFY
(Clarithromycin in Acute Coronary syndrome patients in Finland) also studied the
effect of antibiotic therapy on the secondary prevention of ACS on 148 patients.
The patient selection criteria was subjects with acute non-Q-wave MI
or unstable angina . These patients were randomized to blinded therapy with
either clarithromycin or placebo for three months. The primary endpoint was
composite of death, MI, or unstable...
(Anderson & Muhlestein, 2004)
Atherosclerosis is a disease of epidemic proportions in the western world. Hence a lot of studies have been directed towards this disease till date. Small pilot studies conducted showed a strong association of C. pneuminiae IgG antibody with clinical atherosclerosis. Morever, animal studies have demonstrated the ability of active infection with C. pneumoniae to stimulate or accelerate, and antibiotics to prevent, atherosclerosis ( Anderson & Muhlestein, 2004).
and seropositivity to C.pneumoniae and randomized them to recive either placebo or 3 months of treatment with azithromycin (600mg/week).The primary endpoint was a composite of death, MI, hospitalization for unstable angina or need for repeat revascularization at 3 years. ANTIBIO (Antibiotic therapy after Acute Myocardial Infarction) trials examined treatment with roxithromycin (a macrolide antibiotic) versus placebo for 6 weeks in 872 patients with acute MI. In this case the study end point was death. The ISAR-3 (Intracoronary Stenting and Antibiotic Regimen 3) study investigated roxithromycin, an effective anti-chlamydia macrolide for the prevention of restonosis after coronary stent deployment. ...Show more

Summary

Atherosclerosis is an inflammatory disease and it was believed that high plasma concentrations of cholesterol particularly that of low-density lipoprotein cholesterol was the principal risk factor for atherosclerosis (Rusell, 1999). The possibility that various microbial agents may trigger a cascade of reactions leading to inflammation, atherogenesis, and thrombotic events in vascular system by chronic infection with various agents like Chlamydia pneumoniae, Helicobacter pylori etc…
Author : rachaeljohnston
Literature Critique Antibiotic Trials for Coronary Heart Disease essay example
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