Azithromycin and the Risk of Cardiovascular Death

Azithromycin and the Risk of Cardiovascular Death

Por: Wayne A. Ray, Ph.D., Katherine T. Murray, M.D., Kathi Hall, B.S., Patrick G. Arbogast, Ph.D., y C. Michael Stein, M.B., Ch.B.  N Engl J Med 2012; 366:1881-1890May 17, 2012.

Azithromycin, a broad-spectrum macrolide antibiotic, has been reported to be relatively free of cardiotoxic effects. However, the closely related drugs erythromycin and clarithromycin can increase the risk of serious ventricular arrhythmias and are associated with an increased risk of sudden cardiac death.Furthermore, accumulating evidence suggests that azithromycin also may have proarrhythmic effects. There are at least seven published reports of patients with normal baseline QT intervals in whom azithromycin had arrhythmia-related adverse cardiac effects, including pronounced QT-interval prolongation, torsades de pointes, and polymorphic ventricular tachycardia in the absence of QT-interval prolongation.