Researched as azithromycin-a commonly prescribed antibiotic- Potential treatment for COVID-19..
The link between azithromycin and cardiac events is being discussed. In 2012, the FDA issued a warning against azithromycin. Although azithromycin has been described as being associated with cardiac events, subsequent studies have shown mixed results.
Increased cardiac events
Researchers at the University of Illinois at Chicago have now found that azithromycin alone is not associated with increased cardiac events. However, when the drug is taken with certain other drugs that affect the electrical functioning of the heart, cardiac events increase.
“Our findings should be provided to researchers and clinicians who are considering azithromycin as a potential treatment for the COVID-19 pose.”
“We found that when taken with drugs that affect the electrical impulses of the heart, the combination leads to a 40% increase in cardiac events such as syncope, palpitations, and even cardiac arrest,” Patel added. It was.
Their findings were published in JAMA Network Open.
Drugs that affect the electrical impulses of the heart, especially the intervals of electrical rhythms called the QT interval, are called QT prolongers.
These drugs include blood pressure medications such as ACE inhibitors and beta blockers, some antidepressants, antimalaria drugs such as hydroxychloroquine and chloroquine, opioids, and even muscle relaxants.
“Because QT prolonging drugs are so commonly used, doctors prescribing azithromycin suggest that patients need to make sure they are not taking QT prolonging drugs either,” Patel said. Says.
In a previous study, Patel and colleagues found that one in five people prescribed azithromycin also took QT prolonging medication.
Previous studies of azithromycin and cardiac events investigated certain older, health-prone populations, such as Medicaid patients and veterans.
However, in this study, Patel and colleagues used a large database containing medical data from millions of patients in the United States with an average age of 36 years.
The risk of cardiac events due to azithromycin was assessed against amoxicillin. Amoxicillin is another antibiotic that has never been associated with cardiac events and does not affect the QT interval.
Researchers examined data from more than 4 million patients enrolled in private health insurance who were hospitalized between 2009 and 2015 or visited the emergency department for a cardiac event. The patient began taking either amoxicillin or azithromycin within 5 days of admission.
Each group had about 2 million episodes. Cardiac events include ventricular arrhythmias, syncope, palpitation, cardiac arrest, and death.
“Drugs often prolong the QT interval, but they don’t always result in self-solving cardiac events over time. This study looked at events that could lead to emergency or hospitalization,” Patel said. Said.
Researchers have found that azithromycin-induced cardiac events are not significantly more likely than amoxicillin, and these events are actually very low or rare in both groups, with fainting being the most common cardiac event. It is palpitation.
However, patients taking both QT prolongers and azithromycin had a 40% higher risk of heart events compared to the amoxicillin group.
“Because both QT prolongers and azithromycin are so commonly prescribed, the risk of heart events from the combination is rare but serious,” Patel said.
“Studies considering the use of azithromycin to treat COVID-19 or other disorders should consider its use in patients who are also taking QT prolonging drugs very carefully,” Patel said. He added.
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