Antibiotics for vascular diseases: a meta-analysis of randomized controlled trials.
BACKGROUND
Trials of antibiotic treatment of vascular diseases, in attempts to eradicate possible microbial initiators, have had mixed results. We sought to evaluate the efficacy of antibiotics in treating patients with atherosclerotic vascular diseases, using a meta-analysis.


METHODS
We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials and also used cross-references. Randomized controlled trials of antibiotic treatment of vascular diseases were included. Two independent raters assessed the trials for quality. We performed summary estimates, subgroup analyses and tests for homogeneity.


RESULTS
Twelve trials, with a total of 12,236 patients, were included. Antibiotic treatment resulted in a non-significant reduction in the risk of new vascular events or death (odds ratio (OR), 0.84; 95% confidence interval (CI), 0.67-1.05). There was significant heterogeneity between the sub-groups in type of vascular disease (coronary heart disease, CHD versus non-CHD (p=0.01)). Among the 72 non-CHD patients, a trend appears for treatment benefit in reducing recurrent events or death (OR, 0.22; 95% CI, 0.07-0.66).


CONCLUSIONS
Overall, antibiotic treatment did not significantly reduce occurrence of new vascular events or death. However, further trials are needed to confirm the benefit demonstrated in non-CHD patients.
Illoh
Kachi O
KO
Stroke Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA. koilloh@utmb.edu
Illoh
Orieji C
OC
Feseha
Habteab B
HB
Hallenbeck
John M
JM
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000150:complications / Q000382:microbiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D006801:Humans; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000382:microbiology* / Q000401:mortality / Q000517:prevention & control*
D000900:Anti-Bacterial Agents