Arterial intima-media thickness in 13-year-old adolescents and previous antichlamydial antimicrobial use: a retrospective follow-up study

Pediatrics. 2008 Sep;122(3):e675-81. doi: 10.1542/peds.2008-0220.


Background: Children with persistent Chlamydia pneumoniae infection may be at increased risk for atherosclerosis. The impact of antimicrobial therapy for primary prevention of atherosclerotic cardiovascular disease is unsolved.

Objective: The purpose of this study was to determine whether treatment with antimicrobial agents effective against C pneumoniae during childhood, regardless of indication, has a favorable influence on the arterial wall-thickness in children by the time they reach adolescence.

Subjects and methods: The association of macrolide, tetracycline, quinolone, and rifamycin use (number of exposure events) between ages 5 and 13 years with carotid and aortic intima-media thickness at age 13 years was investigated among 508 healthy children. Information about the use of medications was obtained from the Finnish prescription register. Arterial intima-media thickness was measured with a high-resolution ultrasound.

Results: Mean aortic intima-media thickness showed a significant direct association with the number of antichlamydial antimicrobial exposure events also after controlling for established atherosclerotic risk factors. Elevated C-reactive protein level had an additional effect on aortic intima-media thickness in a multivariable model. Carotid intima-media thickness was not associated with the number of preceding antichlamydial treatments.

Conclusions: Recurrent antichlamydial treatments in childhood have no favorable influence on early vascular changes but are associated with increased intima-media thickness in the abdominal aorta. These findings suggest that the use of antimicrobial agents does not offer protection against the potential atherogenicity of repeated infectious insults.

Trial registration: NCT00223600.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / therapeutic use*
  • Antibodies, Bacterial / analysis
  • Aorta, Abdominal / diagnostic imaging*
  • Atherosclerosis / epidemiology
  • Atherosclerosis / etiology
  • Atherosclerosis / prevention & control*
  • Carotid Artery, Common / diagnostic imaging*
  • Child
  • Child, Preschool
  • Chlamydophila Infections / complications
  • Chlamydophila Infections / drug therapy*
  • Chlamydophila Infections / microbiology
  • Chlamydophila pneumoniae / immunology
  • Chlamydophila pneumoniae / isolation & purification*
  • Female
  • Finland / epidemiology
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Tunica Intima / diagnostic imaging*
  • Ultrasonography


  • Anti-Bacterial Agents
  • Antibodies, Bacterial

Associated data