Some patients may be at increased risk for cardiac death when taking the commonly used antibiotic clarithromycin, a recent Danish study suggests. According to HealthDay, these findings must be confirmed in light of the fact that this drug is prescribed to millions of people each year. The study was published online on August 19th in BMJ.
The authors say that the risk is small, and state that guidelines for use of clarithromycin should not be changed until more research is done. Dr. Suzanne Steinbaum, a preventative cardiologist at Lenox Hill Hospital in New York City, however, told HealthDay “Some commonly used antibiotics should be taken with caution, especially for those people who are at risk for heart disease,”
“As it has been shown before, not all antibiotics are created equal when it comes to increasing the risk of cardiovascular death,” said Dr. Steinbaum. “If you have an underlying heart condition, be certain to discuss it with your doctor before taking an antibiotic prescription. There are definitely safer alternatives.”
The Danish researchers focused on clarithromycin and roxithromycin in their study. Both drugs are part of a group of antibiotics called macrolides, which are believed to increase the risk of potentially fatal heart rhythms.
The authors looked at over 5 million courses of antibiotic treatment
To conduct the study, the authors looked at over 5 million courses of antibiotic treatment with clarithromycin, roxithromycin or penicillin V in Danish adults between the ages of 40 to 74 from 1997 to 2011. During the study period, 18 cardiac deaths occurred during the use of clarithromycin and 32 occurred during use of roxithromycin; 285 cardiac deaths occurred in total.
Overall, there was a 76 percent higher risk of cardiac death with ongoing use of clarithromycin compared to penicillin V when researchers adjusted for other factors. The authors found the absolute risk difference to be 37 cardiac deaths per 1 million courses with clarithromycin, with no elevated risk of cardiac death after treatment is stopped.
A team led by Henrik Svanstrom of the Statens Serum Institut in Copenhagen wrote that the study is “the first large-scale population-based observational study to show significantly increased cardiac risk with clarithromycin and the relative cardiac safety of roxithromycin,”
Dr. Ambreen Khalil, an infectious disease specialist at Staten Island University Hospital in New York City, said that the risk “should still be considered by physicians before prescribing this antibiotic,” even if it is small.
“Patients with underlying heart conditions who are taking medications that affect the heart rhythm may be particularly vulnerable,” Dr. Khalil said to HealthDay.
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