Macrolides & Quinolones and cardiovascular risks

Macrolides & Quinolones and cardiovascular risks: The recent article published in the NEJM, has pointed out the arrhythmogenic potential not only of azithromycin but also of potential alternative antibacterial drugs, and showed an association between the use of erythromycin/clarithromycin/azithromycin and sudden cardiac death, augmented by concomitant use of inhibitors of the cytochrome P-450 3A isozymes that metabolize erythromycin. http://www.nejm.org/doi/full/10.1056/NEJMp1302726?query=TOC Also, azithromycin use was found to be associated with an increased risk of death from cardiovascular causes among patients at high baseline risk. http://www.nejm.org/doi/full/10.1056/NEJMoa1300799?query=TOC Comment: We, the clinicians should always be aware of the risks and benefits of antibacterial therapy in our prescribing policies, the potential of lethal arrhythmias, due to QT-interval prolongation with use of azithromycin, other macrolides, which are generally considered to be safer, and all the quinolones, especially for patients with pre-existing cardiovascular risk factors or clinical conditions in which antibacterial drug therapy has limited or little role.
Source: Doc2Doc BMJ Cardiology - Category: Cardiology Authors: Source Type: forums