Antibiotic therapy in coronary heart disease - Where do we currently stand?

A casual association between Chlamydia pneumoniae infection and atheroscler osis remains unresolved but plausible. Evidence comes from sero-epidemiolog ical data, pathological specimen examinations, animal models and in vitro e xperiments. A number of prospective antibiotic intervention trials targeted against C pneumoniae infection in patients with coronary heart disease are now underway. We remain wary that C pneumoniae infection can persist in ce ll lines (associated with atherosclerosis) despite antibiotic therapy and a lso that reactivation of infection can occur. Issues such as delineating th e patient group that could be targeted for treatment, choice of optimal ant ibiotic regimens, duration of therapy and effective methods of monitoring t reatment response remain controversial and, as yet, unresolved. The relevan ce of persistence of C pneumoniae infection and potential antimicrobial res istance will require equal consideration.