Roxithromycin can induce torsade de pointes and QT prolongation, particularly in patients with underlying risk factors such as congenital complete heart block.
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May warrant QT caution with roxithromycin in patients with heart block; leaves open broader macrolide safety assessment.
We reported a 6-year-old girl who developed torsade de pointes (TdP) after taking roxithromycin. The patient had congenital complete heart block and complex cyanotic heart disease. Before taking roxithromycin, her corrected QT interval (QTc) was 0.39 second with a ventricular rate of 55-60 beats/min. Repetitive bursts of TdP with prolonged QT interval (QTc = 0.55 s) developed after taking roxithromycin. After stopping the medication, her QT interval normalized (QTc = 0.38 s). This case demonstrated the potential of roxithromycin in causing TdP especially in a patient with other risk factors for prolong QT interval and TdP.
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Promphan et al. (2003) studied this question.
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