Preventive Antibacterial Therapy in Acute Ischemic Stroke A Randomized Controlled Trial 英文参考文献.docVIP

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Preventive Antibacterial Therapy in Acute Ischemic Stroke A Randomized Controlled Trial 英文参考文献.doc

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Preventive Antibacterial Therapy in Acute Ischemic Stroke A Randomized Controlled Trial 英文参考文献

PreventiveAntibacterialTherapyinAcuteIschemic Stroke:ARandomizedControlledTrial HendrikHarms1.,KonstantinPrass5.,ChristianMeisel3.,JulianeKlehmet1,WitoldRogge6 ,Christoph Drenckhahn1,JosGo¨hler1,StefanBereswill2,UlfGo¨bel2,KlausDieterWernecke4,TiloWolf8 ,Guy Arnold7,ElkeHalle2,Hans-DieterVolk3,UlrichDirnagl1,AndreasMeisel1* 1Department of Neurology, Charite′ Universitaetsmedizin Berlin, Berlin, Germany, 2Department of Microbiology, Charite′ Universitaetsmedizin Berlin, Berlin, Germany, 3Institute of Medical Immunology, Charite′ Universitaetsmedizin Berlin, Berlin, Germany, 4Department of Biometrics and Clinical Epidemiology, Charite′ Universitaetsmedizin Berlin, Berlin, Germany, 5Department of Neurology, Landesklinikum Waldviertel Horn, Horn, Austria, 6Department of Neurology, Unfallkrankenhaus Berlin, Berlin, Germany, 7Department of Neurology, Klinikum Sindelfingen-Bo¨blingen, Sindelfingen, Germany, 8Department of Neurology, James CookUniversityHospital,Middlesbrough,UnitedKingdom Abstract Background: Pneumonia is a major risk factor of death after acute stroke. In a mouse model, preventive antibacterial therapy with moxifloxacin not only prevents the development of post-stroke infections, it also reduces mortality, and improves neurological outcome significantly. In this study we investigate whether this approach is effective in stroke patients. Methods:PreventiveANtibacterialTHERapyinacuteIschemicStroke(PANTHERIS)isarandomized,double-blind,placebo- controlled trial in 80 patients with severe, non-lacunar, ischemic stroke (NIHSS.11) in the middle cerebral artery (MCA) territory. Patients received either intravenous moxifloxacin (400mg daily) or placebo for 5days starting within 36hours after stroke onset. Primary endpoint was infection within 11days. Secondary endpoints included neurological outcome, survival,developmentofstroke-inducedimmunodepression,andinductionofbacterialresistance. Findings: Onintention-totreatanalysis(79patients),theinfectionrateatday