Antibiotic improves recovery from stroke

An antibiotic can limit brain damage and disability in stroke patients when given within a day of the stroke, a new study suggests.

Researchers designed a study in which they received notification whenever a stroke patient arrived at Edith Wolfson Medical Center in Holon, Israel. Between 2003 and 2005, the team identified 152 people who hadn’t received any medication in the first 6 hours since the onset of their strokes. In all the patients, blood clots had stopped blood flow to parts of their brains.

With patient approval, doctors randomly assigned these patients to receive either oral doses of the antibiotic minocycline or a placebo for 5 days, starting 6 to 24 hours after the stroke. Some of the patients also received aspirin or other blood thinners. None received the powerful clot-busting drug called tissue plasminogen activator (tPA), since it wasn’t approved for use in Israel at the time.

The researchers monitored the patients’ progress over 90 days. Standard tests of disability and neurological function showed that people getting the drug scored significantly better 1 week, 1 month, and 3 months after the stroke than did those getting the placebo, the scientists report in the Oct. 2 Neurology. The scores translated as better ability to handle everyday duties and stronger language, movement, and sensory functions.

As time elapses after a stroke, patients have diminishing medical options. Treatment with tPA is valuable within the first few hours, but after that it can impart a bleeding risk that outweighs its benefits (SN: 7/14/07, p. 26; SN: 2/24/07, p. 126).

In tissues downstream from a clot, which are deprived of blood and oxygen in such strokes, minocycline probably limits cell death and may hinder inflammation, says study coauthor Yair Lampl, a neurologist at Tel-Aviv University.