Clarithromycin Linked to Increased Cardiac Death Risk
(HealthDay News) -- There is a significantly increased risk of cardiac death associated with clarithromycin use, according to a study published online August 19 in BMJ.
Henrik Svanström, from the Statens Serum Institut in Copenhagen, Denmark, and colleagues assessed the risk of cardiac death associated with use of clarithromycin and roxithromycin compared with penicillin V in Danish adults (aged 40–74 years). Participants had received seven-day treatment courses with clarithromycin (160,297 adults), roxithromycin (588,988 adults), and penicillin V (4,355,309 adults).
The researchers observed a total of 285 cardiac deaths. Use of clarithromycin correlated with a significantly increased risk of cardiac death compared with penicillin V (incidence rate, 5.3 vs. 2.5 per 1,000 person years; adjusted rate ratio [RR], 1.76; 95% confidence interval [CI], 1.08–2.85), while use of roxithromycin was not associated with increased risk (incidence rate, 2.5 per 1,000 person years; adjusted RR, 1.04; 95% CI, 0.72–1.51). The most pronounced association of clarithromycin with cardiac death was seen among women (adjusted RRs, 2.83 [95% CI, 1.50–5.36] in women and 1.09 [95% CI, 0.51–2.35] in men). The adjusted absolute risk difference was 37 cardiac deaths per one million courses with clarithromycin and two cardiac deaths per one million courses with roxithromycin, compared with penicillin V.
"Given the widespread use of clarithromycin, these findings call for confirmation in independent populations," the authors write.