Key result
Clarithromycin treatment precipitated acquired long QT syndrome leading to torsades de pointes and cardiac arrest in a 75-year-old woman with multiple risk factors.
Why the study?
Does clarithromycin treatment precipitate prolonged QT interval and torsades de pointes in susceptible patients?
Case Report (n=1)
Does clarithromycin treatment precipitate prolonged QT interval and torsades de pointes in susceptible patients?
This case highlights the risk of acquired long QT syndrome and life-threatening torsades de pointes associated with macrolide antibiotics like clarithromycin, particularly in patients with multiple risk factors.
Alerts to clarithromycin-associated TdP risk in vulnerable patients; leaves open need for prospective incidence data.
A 75-year-old woman presenting with pre-syncope, shortness of breath and nausea was admitted to the emergency department following treatment with clarithromycin. Shortly after admission she developed a prolonged QT interval leading to torsades de pointes (TdP) and cardiac arrest. She was successfully cardioverted and clarithromycin was discontinued resulting in restoration of her usual QT interval. This case is an example of acquired long QT syndrome; a disorder that can be precipitated by macrolide antibiotics such as clarithromycin. Additional risk factors present in this case include: female gender, old age, heart disease, hypokalemia and hypomagnesemia. In this manuscript we comprehensively review past cases of clarithromycin-induced long QT syndrome (LQTS) and discuss them within the context of this case.
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Gysel et al. (2013) conducted a case report in Torsades de pointes / Acquired long QT syndrome (n=1). Clarithromycin was evaluated on Prolonged QT interval leading to torsades de pointes and cardiac arrest. Clarithromycin treatment precipitated acquired long QT syndrome leading to torsades de pointes and cardiac arrest in a 75-year-old woman with multiple risk factors.
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