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Quinolone Safety and Efficacy

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      Most cited references 12

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      Guidelines for the management of adults with community-acquired pneumonia. Diagnosis, assessment of severity, antimicrobial therapy, and prevention.

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          Antibiotic treatment of Chlamydia pneumoniae after acute coronary syndrome.

          Chlamydia pneumoniae has been found within atherosclerotic plaques, and elevated titers of antibody to this organism have been linked to a higher risk of coronary events. Pilot studies have suggested that antibiotic treatment may reduce the risk of cardiovascular events. We enrolled 4162 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and evaluated the efficacy of long-term treatment with gatifloxacin, a bactericidal antibiotic known to be effective against C. pneumoniae, in a double-blind, randomized, placebo-controlled trial. Subjects received 400 mg of gatifloxacin daily during an initial 2-week course of therapy that began 2 weeks after randomization, followed by a 10-day course every month for the duration of the trial (mean duration, 2 years), or placebo. The primary end point was a composite of death from all causes, myocardial infarction, documented unstable angina requiring rehospitalization, revascularization (performed at least 30 days after randomization), and stroke. A Kaplan-Meier analysis revealed that the rates of primary-end-point events at two years were 23.7 percent in the gatifloxacin group and 25.1 percent in the placebo group (hazard ratio, 0.95; 95 percent confidence interval, 0.84 to 1.08; P=0.41). No benefit was seen in any of the prespecified secondary end points or in any of the prespecified subgroups, including patients with elevated titers to C. pneumoniae or C-reactive protein. Despite long-term treatment with a bactericidal antibiotic effective against C. pneumoniae, no reduction in the rate of cardiovascular events was observed. Copyright 2005 Massachusetts Medical Society.

            Author and article information

            [* ]Christ Hospital, Jersey City, New Jersey, USA
            [* ]Veterans Affairs Medical Center and Duke University Medical Center, Durham, North Carolina, USA
            Author notes
            Address for correspondence: Spartaco Bellomo, Christ Hospital, Division of Infectious Diseases, 142 Palisade Ave, Jersey City, NJ 07306, USA; fax: 201-653-6697; email: idbells@
            Emerg Infect Dis
            Emerging Infect. Dis
            Emerging Infectious Diseases
            Centers for Disease Control and Prevention
            June 2005
            : 11
            : 6
            : 985-987
            3367587 04-0740 10.3201/eid1106.040740
            Letters to the Editor

            Infectious disease & Microbiology

            safety, fluoroquinolones, keywords: efficacy


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