Roxithromycin treatment prevents progression of peripheral arterial occlusive disease in Chlamydia pneumoniae seropositive men: a randomized, double-blind, placebo-controlled trial.
BACKGROUND
Evidence has been provided that the atherosclerotic process may be associated with chronic infection with Chlamydia pneumoniae. The effect of antibiotic treatment on peripheral arterial occlusive disease has not been investigated yet.


RESULTS
Forty C pneumoniae seropositive men suffering from peripheral arterial occlusive disease were randomly assigned to receive either roxithromycin (300 mg daily) or placebo for 28 days. During the 2.7-year follow-up, the number of invasive revascularizations per patient, the walking distance before intervention (in patients without intervention at study end), and the change of carotid plaque size were assessed. Five interventions were performed on 4 patients (20%) in the roxithromycin group, and 29 interventions were performed on 9 patients (45%) in the placebo group. Limitation of walking distance to 200 m or less was observed in 4 patients (20%) in the roxithromycin group and in 13 patients (65%) in the placebo group. The effect of macrolide treatment on the number of interventions per patient and on preinterventional walking distance was significant. Possible confounding variables such as classical vascular risk factors were excluded by multiple regression analyses. Carotid plaque areas monitored over 6 months decreased in the roxithromycin group (mean relative value, 94.4%) but remained constant in the placebo group (100.2%). Regression of carotid plaque size observed in roxithromycin-treated patients was significant for soft plaques.


CONCLUSIONS
This study indicates that macrolide treatment for 1 month is effective in preventing C pneumoniae seropositive men from progression of lower limb atherosclerosis for several years.
Wiesli
Peter
P
Department of Internal Medicine, Medical Policlinic, University Hospital, Zurich, Switzerland.
Czerwenka
Wolfgang
W
Meniconi
Alfredo
A
Maly
Friedrich E
FE
Hoffmann
Ulrich
U
Vetter
Wilhelm
W
Schulthess
Georg
G
D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000907:Antibodies, Bacterial / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D023521:Chlamydophila Infections / Q000097:blood / Q000150:complications* / Q000276:immunology; D016993:Chlamydophila pneumoniae / Q000276:immunology; D015986:Confounding Factors, Epidemiologic; D003967:Diarrhea / Q000139:chemically induced; D018450:Disease Progression; D004311:Double-Blind Method; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control*; D012044:Regression Analysis; D012307:Risk Factors; D015575:Roxithromycin / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D016138:Walking
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial; D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D015575:Roxithromycin; D002097:C-Reactive Protein