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Article: Azithromycin, cardiovascular risks, QTc interval prolongation, torsade de pointes, and regulatory issues: A narrative review based on the study of case reports.

Hancox, Jules C / Hasnain, Mehrul / Vieweg, W Victor R / Crouse, Ericka L Breden / Baranchuk, Adrian

Therapeutic advances in infectious disease

2014  Volume 1, Issue 5, Page(s) 155–165

Abstract: ... to azithromycin-induced/associated QTc interval prolongation and torsade de pointes. We found 12 cases: seven ... QTc interval prolongation and torsade de pointes. ... prolongation and torsade de pointes. The FDA wants healthcare providers to consider azithromycin-induced fatal ...

Abstract Over the past year, three articles have appeared in the New England Journal of Medicine describing conflicting findings about azithromycin and cardiac safety, particular azithromycin-induced QTc interval prolongation and torsade de pointes. The FDA wants healthcare providers to consider azithromycin-induced fatal cardiac arrhythmias for patients already at risk for cardiac death and other potentially arrhythmogenic cardiovascular conditions. In a systematic review of case reports we sought to determine factors that link to azithromycin-induced/associated QTc interval prolongation and torsade de pointes. We found 12 cases: seven female and five male. Of the nine adults with reported azithromycin doses, concurrent QTc interval measurement, and without congenital long QT syndrome, we found no significant relationship between dose and QTc interval duration. Additional risk factors were female sex, older age, heart disease, QTc interval prolonging drugs and metabolic inhibitors, hypokalemia, and bradycardia. All 12 subjects had at least two additional risk factors. Elderly women with heart disease appear to be at particularly risk for drug-related QTc interval prolongation and torsade de pointes.
Language English
Publishing date 2014-01-13
Publishing country England
Document type Journal Article
ZDB-ID 2728410-4
ISSN 2049-937X ; 2049-9361
ISSN (online) 2049-937X
ISSN 2049-9361
DOI 10.1177/2049936113501816
Database MEDical Literature Analysis and Retrieval System OnLINE

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