Journal of Antimicrobial Chemotherapy, Vol 41, 85-92, Copyright © 1998 by The British Society for Antimicrobial Chemotherapy
J Sinisalo, K Mattila, MS Nieminen, V Valtonen, M Syrjala, S Sundberg and P Saikku
Chronic Chlamydia pneumoniae infection, characterized by elevated levels of
C. pneumoniae IgG and IgA antibodies and immunocomplexes, is associated
with myocardial infarction and angiographically verified coronary heart
disease. C. pneumoniae organisms have also been found in coronary
atheromas, but not in healthy vessels. We investigated the effect of 4
months' doxycycline therapy on serological markers of C. pneumoniae
infection and coronary risk factors. Thirty-four non-smoking men, aged 57.9
(+/- 5.2) years, who had mild hypertension or moderate
hypercholesterolaemia and a previous coronary bypass, were randomly
assigned to receive doxycycline or matching placebo for 4 months.
Acetylsalicylic acid and beta-blocker were the only other medications
allowed. Patients were examined physically and by laboratory tests; their
basal nitric oxide production was determined by blood flow responses to
intra-arterial monomethyl-L-arginine at baseline and at 2 and 4 months. The
tests were also taken at 6 months after medication. At entry, the
demographic, clinical, blood flow and laboratory measurements were similar
in both groups, with the exception of fibrinogen and triglyceride levels,
which were higher in the placebo group. No significant changes were found
in any of the parameters during the treatment. Thus extended doxycycline
therapy did not affect C. pneumoniae antibodies or coronary heart disease
risk factors. We conclude that doxycycline monotherapy may not be
sufficient to eradicate chronic C. pneumoniae infection.
ORIGINAL ARTICLES
The effect of prolonged doxycycline therapy on Chlamydia pneumoniae serological markers, coronary heart disease risk factors and forearm basal nitric oxide production
Department of Medicine, Helsinki University Central Hospital, Finland. Juha.Sinisalo@HYKS.mailnet.fi
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