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Study raises concerns over macrolides in CHD patients

A new study raises concerns over use of macrolide antibiotics in patients with coronary heart disease ­ after finding clarithromycin appeared to significantly raise mortality.

The findings came in a trial to see whether clarithromycin could reduce deaths in patients with stable CHD by killing Chlamydia pneumoniae bacteria.

In the US, the Food and Drug Administration issued an alert to doctors urging them to be aware of the study. It follows research first reported by Pulse in September last year finding macrolides were associated with an increased risk of cardiac death.

Study leader Dr Christian Jespersen, consultant physician in cardiology at Copenhagen University Hospital, Denmark, said: 'Short-term, clarithromycin in patients with stable CHD may cause significantly higher cardiovascular mortality.'

The trial of 4,373 patients aged 18 to 85 ­ published online by the BMJ ­ found CVD mortality was 45 per cent higher in those taking the drug versus placebo. All-cause mortality was 27 per cent higher.

Dr Brian Crichton, honorary lecturer in therapeutics and pharmacology at the University of Warwick, said: 'It does create a question-mark over our use of macrolides in patients with CVD. We need to exercise some care on prescribing macrolides.'

The Medicines and Healthcare Products Regulatory Agency said: 'These results are unexpected and not supported by the available evidence.'

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