Do Benefits of Azithromycin for Pneumonia Outweigh Risks in Older Patients?
the MPR take:
Although studies have suggested that treatment for pneumonia with macrolides that include azithromycin could increase the risk of cardiovascular events, the net benefit is greater than the risk of myocardial infarction (MI). Data from 73,690 patients ≥65 years of age hospitalized with pneumonia from 2002–2012 was analyzed in a retrospective cohort study; patients were prescribed either azithromycin therapy or another clinical practice guideline-concordant antibiotic therapy. Ninety-day mortality was significantly lower in the group receiving azithromycin, but the odds of MI (but not other cardiovascular events) was also significantly increased. Even with the increased MI risk, the net benefit outweighs the risks for patients taking azithromycin for pneumonia.
Importance: Although clinical practice guidelines recommend combination therapy with macrolides, including azithromycin, as first-line therapy for patients hospitalized with pneumonia, recent research suggests that azithromycin may be associated with increased cardiovascular events. ...
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