Arrhythmia Warnings for Macrolide Antibiotics May Be Overstated, Study Finds

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Findings in older adults show macrolide antibiotics are linked to lower risk of all-cause mortality
Findings in older adults show macrolide antibiotics are linked to lower risk of 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 four 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.

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

"These findings suggest that current warnings from the U.S. Food and Drug Administration may be overstated," the authors write.

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

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