Macrolide Antibiotics Not Associated With Higher Risk of Ventricular Arrhythmia

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Macrolide antibiotics were associated with a lower risk of 30-day all-cause mortality.
Macrolide antibiotics were associated with a lower risk of 30-day all-cause mortality.

HealthDay News – For older adults, macrolide antibiotics are not associated with a higher risk of ventricular arrhythmia within 30 days compared with nonmacrolide antibiotics, according to a study published online February 22 in CMAJ, the journal of the Canadian Medical Association.

Mai H. Trac, from Western University in London, Canada, and colleagues conducted a population-based retrospective cohort study involving adults aged older than 65 years with a new prescription for an oral macrolide antibiotic in Ontario, Canada, from 2002 to 2013. Using propensity scores, patients were matched in a 1:1 ratio to controls prescribed nonmacrolide antibiotics. The analyses were repeated in 4 subgroups defined by the presence or absence of chronic kidney disease, congestive heart failure, coronary artery disease, and concurrent use of a drug known to prolong QT interval.

Researchers found that macrolide antibiotics were not associated with a higher risk of ventricular arrhythmia compared with nonmacrolide antibiotics (0.03% vs 0.03%; relative risk [RR]: 1.06; 95% confidence interval [CI], 0.83-1.36). However, macrolide antibiotics were associated with a lower risk of 30-day all-cause mortality (0.62% vs 0.76%; RR: 0.82; 95% CI: 0.78-0.86). Similar correlations were seen in all subgroups.

"These findings suggest that current warnings from the US Food and Drug Administration may be overstated," the authors wrote.

Disclosures: One author's institution received unrestricted research funding from Pfizer.

Reference

Trac MH, McArthur E, Jandoc R, et al. Macrolide antibiotics and the risk of ventricular arrhythmia in older adults. CMAJ. 2016. doi:10.1503/cmaj.150901.

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