Table 1.

Clinical studies of antibiotic treatment in patients with stroke

Study	Design	Stroke type	Sample size	Antibiotics regimen	Primary outcomes	Conclusion on patients' outcome	Conclusion on infection
Halms et al61	Phase 2, randomised, double-blind, placebo controlled	Ischaemic	79	Moxifloxacin, 400 mg daily for 5 days starting within 36 hours	Infection within 11 days	Improved neurological outcome and survival.	Reduced infection.
Chamorro et al62	Phase 2, randomised, double-blind, placebo-controlled	Ischaemic/haemorrhagic (110/26)	136	Levofloxacin, 500 mg daily for 3 days, starting within 24 hours	Incidence of infection 7 days after stroke	Levofloxacin could lessen the chances of functional recovery.	Did not prevent infection.
Schwarz et al63	Phase 2, randomised, controlled	Ischaemic	60	Mezlocillin plus sulbactam, 2 g/1 g every 8 hours for 4 days, starting within 24 hours	Incidence and height of fever	May be associated with a better clinical outcome.	Decreased infection.
Amiri-Nikpour et al11	Phase 2, open-label, evaluator-blinded	Ischaemic	53	Minocycline 200 mg daily for 5 days, starting from 6 hours to 24 hours	NIHSS score at 90 days	Better outcomes at 90 days in the minocycline group.	NA
Kohler et al13	Phase 2, randomised open-label, blinded end point evaluation	Ischaemic/haemorrhagic (77/11)	95	Minocycline 100 mg every 12 hours, five doses in total, within 24 hours	mRS at 90 days	Safe but not efficacious.	NA
Lampl et al12	Phase 2, open-label, evaluator-blinded	Ischaemic	152	Minocycline 200 mg daily for 5 days, starting within 6–24 hours	NIHSS change from baseline to 90 days	Improved patients’ outcome at 90 days.	NA
Ulm et al15	Phase 2, randomised, controlled	Ischaemic	197	PCTus-guided antibiotic, starting within 40 hours for 7 days	mRS at 3 months	Did not improve functional outcome at 3 months.	Did not reduce pneumonia.
Westendorp et al8	Phase 3, randomised, open-label, masked	Ischaemic/haemorrhagic (2125/269)	2538	ceftriaxone 2 g, intravenously once daily for 4 days starting within 24 hours after onset	mRS at 3 months	Did not improve functional outcome at 3 months	Reduced all infection rates and urinary tract infection rates, but not pneumonia.
Kalra et al7	Phase 3, cluster-randomised, open-label, masked	Ischaemic/haemorrhagic (1091/125)	1217	Antibiotic conformed to local policy, starting within 48 hours, for 7 days	Pneumonia in the first 14 days	Did not improve neurological function and outcome.	Did not reduce pneumonia.

mRS, modified Rankin Scale; NA, not available; NIHSS, National Institute of Health Stroke Scale; PCTus, procalcitonin ultrasensitive.