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December 1, 1999

Antibiotic Use and Risk of Myocardial Infarction—Reply

Author Affiliations

Phil B.FontanarosaMD, Interim CoeditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephenLurieMD PhD, Fishbein FellowIndividualAuthor

JAMA. 1999;282(21):1997-1999. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-21-jbk1201

In Reply: Dr Haider and colleagues state that residual confounding, chance, or bias may be alternative explanations for our findings. We agree, as discussed in detail in our article. However, 3 reasons speak against selection bias (ie, antibiotic users differ from nonusers with regard to cardiovascular risk factors and medical attention sought): (1) there were no subjects with diagnosed cardiovascular diseases in our study; (2) we adjusted the analysis for number of practice visits (and therefore for medical attention sought) with no effect on the results; and (3) we analyzed antibiotic use in groups and not just users vs nonusers, which would mean that any bias had to selectively affect users of certain antibiotics but not others.