Standard CAD Care Should Not Include Antibiotics

Two recent randomized trials, one of azithromycin and one of gatifloxacin, failed to show any secondary-prevention benefit of these antibiotics in patients with established coronary artery disease (CAD). These findings are now reinforced by a meta-analysis of 11 randomized, placebo-controlled trials (involving 19,217 patients) of antichlamydial antibiotics in patients who had stable CAD or presented with acute coronary syndromes (ACS).

Follow-up in the 11 trials ranged from 6 months to 4 years. In a pooled analysis, antibiotic therapy (most often azithromycin) was not significantly better than placebo for preventing death from any cause, MI, or MI/unstable angina combined.