Key result
Azithromycin carries a risk of QT prolongation and torsades de pointes, but the absolute risk of cardiovascular death is miniscule for most otherwise-healthy patients without preexisting risk factors.
Why the study?
Does azithromycin increase the risk of sudden cardiac death and fatal arrhythmias in patients with cardiovascular risk factors?
Does azithromycin increase the risk of sudden cardiac death and fatal arrhythmias in patients with cardiovascular risk factors?
Azithromycin carries a small absolute risk of QT prolongation and sudden cardiac death that is primarily clinically relevant in patients with preexisting cardiovascular risk factors, warranting careful patient selection.
Answers are grounded in this paper and cite their sources.
Minimal absolute CV death risk supports azithromycin in low-risk patients; leaves open precise estimates in those with preexisting factors.
A march 2013 warning by the US Food and Drug Administration that azithromycin (Zithromax, Zmax, Z-pak) may increase the risk of sudden cardiac death does not mean we must abandon using it. We should, however, try to determine if our patients have cardiovascular risk factors for this extreme side effect and take appropriate precautions.
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Giudicessi et al. (2013) conducted a review in Bacterial infections and risk of sudden cardiac death. Azithromycin vs. Alternative antibiotics or no antibiotic was evaluated. Azithromycin carries a risk of QT prolongation and torsades de pointes, but the absolute risk of cardiovascular death is miniscule for most otherwise-healthy patients without preexisting risk factors.
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