(Press-News.org) In a study that included nearly 65,000 older patients hospitalized with pneumonia, treatment that included azithromycin compared with other antibiotics was associated with a significantly lower risk of death and a slightly increased risk of heart attack, according to a study in the June 4 issue of JAMA.
Pneumonia and influenza together are the eighth leading cause of death and the leading causes of infectious death in the United States. Although clinical practice guidelines recommend combination therapy with macrolides (a class of antibiotics), including azithromycin, as first-line therapy for patients hospitalized with pneumonia, recent research suggests that azithromycin may be associated with increased cardiovascular events, according to background information in the article.
Eric M. Mortensen, M.D., M.Sc., of the VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas, and colleagues assessed the association of azithromycin use and outcomes within 90 days of hospital admission, including cardiovascular events (heart failure, heart attack, cardiac arrhythmias) and death, for patients 65 years and older who were hospitalized with pneumonia at any Veterans Administration acute care hospital from fiscal years 2002 through 2012.
The final analysis included 31,863 patients who received azithromycin and 31,863 matched patients who did not, but some other guideline-concordant therapy. The researchers found that 90-day mortality was significantly lower in those who received azithromycin (17.4 percent, vs 22.3 percent). There was also an increased odds of heart attack (5.1 percent vs 4.4 percent), but not any cardiac event (43.0 percent vs 42.7 percent), cardiac arrhythmias (25.8 percent vs 26.0 percent), or heart failure (26.3 percent vs 26.2 percent).
"In this national cohort study of veterans hospitalized with pneumonia, azithromycin use was consistently associated with decreased mortality and a slightly increased odds of myocardial infarction," the authors write. "To put the balance of benefits and harms in context, based on the propensity-matched analysis, the number needed to treat with azithromycin was 21 to prevent 1 death within 90 days, compared with a number needed to harm of 144 for myocardial infarction. This corresponds to a net benefit of around 7 deaths averted for 1 nonfatal myocardial infarction induced."
INFORMATION:
"These findings are consistent with a net benefit associated with azithromycin use in patients hospitalized for pneumonia."
(doi:10.1001/jama.2014.4304; Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note:
Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Outcomes for older adults with pneumonia who receive treatment including azithromycin
2014-06-03
ELSE PRESS RELEASES FROM THIS DATE:
Preventive placement of ICDs for less severe heart failure may improve survival
2014-06-03
An examination of the benefit of preventive placement of implantable cardioverter-defibrillators (ICDs) in patients with a less severe level of heart failure, a group not well represented in clinical trials, finds significantly better survival at three years than that of similar patients with no ICD, according to a study in the June 4 issue of JAMA.
Although clinical trials have established the ICD as the best currently available therapy to prevent sudden cardiac death in patients with heart failure, some uncertainties remain regarding preventive use of ICDs in patients ...
Study: New test predicts if breast cancer will spread
2014-06-03
June 3, 2014 – BRONX, NY – The study was led by researchers at the National Cancer Institute (NCI)─designated Albert Einstein Cancer Center of Albert Einstein College of Medicine of Yeshiva University and Montefiore Einstein Center for Cancer Care and was published online today in the Journal of the National Cancer Institute (JNCI).
"Tests assessing metastatic risk can help doctors identify which patients should receive aggressive therapy and which patients should be spared," said Thomas Rohan, M.D., Ph.D., the lead and corresponding author of the study and professor ...
Deeper than ancestry.com, 'EvoCor' identifies gene relationships
2014-06-03
A frontier lies deep within our cells.
Our bodies are as vast as oceans and space, composed of a dizzying number of different types of cells. Exploration reaches far, yet the genes that make each cell and tissue unique have remained largely obscure.
That's changing with the help of a team led by Gregorio Valdez, an assistant professor at the Virginia Tech Carilion Research Institute.
Valdez and his team designed a search engine – called EvoCor – that identifies genes that are functionally linked.
The name, a portmanteau of "evolution" and "correlation," points to ...
New definition of kidney disease for clinical trials could lead to new treatments
2014-06-03
A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health suggests that new therapies for kidney disease could be developed more quickly by revising the definition of kidney disease progression used during clinical trials. If adopted, the new definition could shorten the length of some clinical trials and also potentially encourage more clinical trials in kidney disease. The findings will be published in the June 3, 2014 online edition of the Journal of the American Medical Association.
Chronic kidney disease (CKD) is a worldwide public health ...
2-D transistors promise a faster electronics future
2014-06-03
Faster electronic device architectures are in the offing with the unveiling of the world's first fully two-dimensional field-effect transistor (FET) by researchers with the Lawrence Berkeley National Laboratory (Berkeley Lab). Unlike conventional FETs made from silicon, these 2D FETs suffer no performance drop-off under high voltages and provide high electron mobility, even when scaled to a monolayer in thickness.
Ali Javey, a faculty scientist in Berkeley Lab's Materials Sciences Division and a UC Berkeley professor of electrical engineering and computer science, led ...
Investigating unusual three-ribbon solar flares with extreme high resolution
2014-06-03
The 1.6 meter telescope at Big Bear Solar Observatory (BBSO) in California has given researchers unparalleled capability for investigating phenomena such as solar flares. Operated by New Jersey Institute of Technology (NJIT), the BBSO instrument is the most powerful ground-based telescope dedicated to studying the star closest to Earth.
On June 2, Distinguished Professor of Physics Haimin Wang joined NJIT colleagues at the 224th meeting of the American Astronomical Society (AAS), held in Boston, Massachusetts, to present intriguing data about solar flares — specifically, ...
Solving sunspot mysteries
2014-06-03
Multi-wavelength observations of sunspots with the 1.6-meter telescope at Big Bear Solar Observatory (BBSO) in California and aboard NASA's IRIS spacecraft have produced new and intriguing images of high-speed plasma flows and eruptions extending from the Sun's surface to the outermost layer of the solar atmosphere, the corona. Operated by New Jersey Institute of Technology (NJIT), BBSO houses the largest ground-based telescope dedicated to solar research.
On June 2, NJIT researchers reported on the acquisition of these images at the 224th meeting of the American Astronomical ...
Complex neural circuitry keeps you from biting your tongue
2014-06-03
DURHAM, N.C. -- Eating, like breathing and sleeping, seems to be a rather basic biological task. Yet chewing requires a complex interplay between the tongue and jaw, with the tongue positioning food between the teeth and then moving out of the way every time the jaw clamps down to grind it up.
If the act weren't coordinated precisely, the unlucky chewer would end up biting more tongue than burrito.
Duke University researchers have used a sophisticated tracing technique in mice to map the underlying brain circuitry that keeps mealtime relatively painless. The study, ...
Climate engineering can't erase climate change
2014-06-03
Tinkering with climate change through climate engineering isn't going to help us get around what we have to do says a new report authored by researchers at six universities, including Simon Fraser University.
After evaluating a range of possible climate-altering approaches to dissipating greenhouse gases and reducing warming, the interdisciplinary team concluded there's no way around it. We have to reduce the amount of carbon being released into the atmosphere.
"Some climate engineering strategies look very cheap on paper. But when you consider other criteria, like ...
Fatty liver disease prevented in mice
2014-06-03
Studying mice, researchers have found a way to prevent nonalcoholic fatty liver disease, the most common cause of chronic liver disease worldwide. Blocking a path that delivers dietary fructose to the liver prevented mice from developing the condition, according to investigators at Washington University School of Medicine in St. Louis.
The study appears in a recent issue of the Journal of Biological Chemistry.
In people, nonalcoholic fatty liver disease often accompanies obesity, elevated blood sugar, high blood pressure and other markers of metabolic syndrome. Some ...