Issue 168 Item 3 Antibiotic Use Tied to Reduced Stroke Risk

Use of antibiotics, especially penicillin, is associated with a decreased risk of stroke.

Dr. Paul Brassard, from Royal Victoria Hospital in Montreal, and colleagues analyzed data from 1888 stroke patients and 9440 matched controls that were drawn from an elderly population being treated for hypertension.

The new findings are consistent with an increasing number of reports that have tied infections with atherosclerosis and thrombosis.

Current antibiotic use or use within the last year was associated with a drop in stroke risk of about 20%. On multivariate analysis, several antibiotic classes were tied to a decreased stroke risk, but the only one that showed a significant relationship was the penicillins.

Current penicillin users were 47% less likely to experience a stroke than non-users, the researchers note. Past penicillin use was also beneficial, but the risk reduction was not as high as with current use.
Dr. Paul Brassard believes that, "The only explanation is that because penicillins are so broad spectrum they may destroy" not just C. pneumonia, but other bacteria that can contribute to atherosclerosis, he added.

"There may be some benefit to macrolides or fluoroquinolones, but because of small patient numbers, the associations were not statistically significant," Dr. Brassard pointed out.

"Two or three randomized trials are currently underway to see if antibiotic therapy can prevent cardiovascular events in MI patients," he added. "If these go well, I think we’ll see some trials investigating antibiotics for the primary prevention" of such events. Stroke 2003;34

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