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The venerable antibiotic, minocycline, has anti-inflammatory effects that have led to its use for treatment of inflammatory arthritis and some other illnesses not thought to have infectious etiologies. In animal models of acute stroke, minocycline has improved outcomes. The presumed mechanisms of protection involve reducing the inflammatory response to ischemia and the associated rate of cell death (apoptosis).
An Israeli team randomized 151 patients with acute ischemic stroke to receive either minocycline (200 mg daily for 5 days) or placebo. All patients were treated within the first 6 to 24 hours of symptoms and followed for 90 days. The investigators used three validated instruments for measuring stroke outcome; evaluators were blinded t…