Trial reportPloS one2008
Preventive antibacterial therapy in acute ischemic stroke: a randomized controlled trial.
Trial report in PloS one, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02726685 (Effects of Respiratory Training on Respiratory and Functional Performance in Patients With Stroke), which is not on this map. Cited by 100 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Respiratory Training on Respiratory and Functional Performance in Patients With Stroke
Who cites it
100 citing papers in PubMed, 11 syntheses or guidelines pooled it, 240 citations in OpenAlex.
- European stroke organisation guideline on stroke-associated pneumonia.European stroke journal · 2026Guideline
- Adjunctive cytoprotective therapies in acute ischemic stroke: a systematic review.Fluids and barriers of the CNS · 2021Pooled it
- Cardioembolic Ischemic Stroke Gene Expression Fingerprint in Blood: a Systematic Review and Verification Analysis.Translational stroke research · 2020Pooled it
- Infection Prevention in the Neurointensive Care Unit: A Systematic Review.Neurocritical care · 2019Pooled it
- Fluoroquinolones and Cardiovascular Risk: A Systematic Review, Meta-analysis and Network Meta-analysis.Drug safety · 2019Pooled it
- Antibiotic therapy for preventing infections in people with acute stroke.The Cochrane database of systematic reviews · 2018Pooled it
- Fluoroquinolones increase the risk of serious arrhythmias: A systematic review and meta-analysis.Medicine · 2017Pooled it
- Pooled it
- The Efficacy of Prophylactic Antibiotics on Post-Stroke Infections: An Updated Systematic Review and Meta-Analysis.Scientific reports · 2016Pooled it
- Systematic study of cilostazol on secondary stroke prevention: a meta-analysis.European journal of medical research · 2013Pooled it
- Post-stroke infection: a systematic review and meta-analysis.BMC neurology · 2011Pooled it
- A randomized trial of Trendelenburg position for acute moderate ischemic stroke.Nature communications · 2023Trial
- Preventive ceftriaxone in patients at high risk of stroke-associated pneumonia. A post-hoc analysis of the PASS trial.PloS one · 2022Trial
- Stroke-induced immunodepression and dysphagia independently predict stroke-associated pneumonia - The PREDICT study.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2017Trial
- Preventive Ceftriaxone in Patients with Stroke Treated with Intravenous Thrombolysis: Post Hoc Analysis of the Preventive Antibiotics in Stroke Study.Cerebrovascular diseases (Basel, Switzerland) · 2016Trial
- Trial
- Update of the Preventive Antibiotics in Stroke Study (PASS): statistical analysis plan.Trials · 2014Trial
- Endovascular therapeutic hypothermia for acute ischemic stroke: ICTuS 2/3 protocol.International journal of stroke : official journal of the International Stroke Society · 2014Trial
- The SCIentinel study--prospective multicenter study to define the spinal cord injury-induced immune depression syndrome (SCI-IDS)--study protocol and interim feasibility data.BMC neurology · 2013Trial
- Intravenous thrombolysis plus hypothermia for acute treatment of ischemic stroke (ICTuS-L): final results.Stroke · 2010Trial
40 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPneumonia 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.
methodsPreventive ANtibacterial THERapy in acute Ischemic Stroke (PANTHERIS) is a randomized, 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 (400 mg daily) or placebo for 5 days starting within 36 hours after stroke onset. Primary endpoint was infection within 11 days. Secondary endpoints included neurological outcome, survival, development of stroke-induced immunodepression, and induction of bacterial resistance.
findingsOn intention-to treat analysis (79 patients), the infection rate at day 11 in the moxifloxacin treated group was 15.4% compared to 32.5% in the placebo treated group (p = 0.114). On per protocol analysis (n = 66), moxifloxacin significantly reduced infection rate from 41.9% to 17.1% (p = 0.032). Stroke associated infections were associated with a lower survival rate. In this study, neurological outcome and survival were not significantly influenced by treatment with moxifloxacin. Frequency of fluoroquinolone resistance in both treatment groups did not differ. On logistic regression analysis, treatment arm as well as the interaction between treatment arm and monocytic HLA-DR expression (a marker for immunodepression) at day 1 after stroke onset was independently and highly predictive for post-stroke infections.
interpretationPANTHERIS suggests that preventive administration of moxifloxacin is superior in reducing infections after severe non-lacunar ischemic stroke compared to placebo. In addition, the results emphasize the pivotal role of immunodepression in developing post-stroke infections.
trial registrationControlled-Trials.com ISRCTN74386719.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.