Key result
In a cohort of hospitalized patients with prolonged QTc who subsequently received azithromycin, the incidence of sustained ventricular tachycardia was 0.97%.
Why the study?
Does azithromycin cause sustained ventricular tachycardia in hospitalized patients with prolonged QTc (>450 ms)?
Cohort (n=103)
No
Does azithromycin cause sustained ventricular tachycardia in hospitalized patients with prolonged QTc (>450 ms)?
In a small retrospective cohort of hospitalized patients with prolonged QTc (>450 ms), the administration of azithromycin was associated with a very low incidence (0.97%) of sustained ventricular tachycardia.
Incidence data inform risk in QTc-prolonged patients; leaves open causal inference and need for prospective trials.
BACKGROUND: Azithromycin has been associated with abnormalities of cardiac repolarization and development of torsades de pointes. Observational data suggest that the risk of death from cardiovascular causes is increased in patients taking azithromycin. Little is known regarding the risk of ventricular arrhythmia in patients with prolongation of the corrected QT interval who receive azithromycin. OBJECTIVE: The purpose of this study was to determine the incidence of sustained ventricular tachycardia in patients with prolonged corrected QT (QTc) who subsequently received azithromycin. METHODS: We performed a retrospective cohort analysis of the incidence of sustained ventricular tachycardia in patients with prolonged QTc (greater than 450 ms) who successively received intravenous (IV) and/or oral azithromycin. Patients hospitalized in a tertiary care teaching hospital between November 2009 and June 2012 were included in the study. The primary outcome was sustained ventricular tachycardia documented in patients on telemetry. RESULTS: Of the 103 patients enrolled in the study, only one patient experienced the primary outcome (0.97 %). The event occurred 1 day after the administration of a single dose of 500 mg IV azithromycin. CONCLUSION: The risk of sustained ventricular tachycardia was 0.97 % in our cohort of patients with prolonged QTc who subsequently received azithromycin. Given the small size of this study, additional research is needed to determine the true incidence of arrhythmia in the population.
No takes yet. Share an insight, caveat, or question.
Sears et al. (2016) conducted a cohort in Prolonged QTc (n=103). Azithromycin was evaluated on Sustained ventricular tachycardia documented on telemetry. In a cohort of hospitalized patients with prolonged QTc who subsequently received azithromycin, the incidence of sustained ventricular tachycardia was 0.97%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: