Document Detail

The cardiotoxicity of macrolides: a systematic review.
MedLine Citation:
PMID:  21038838     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We aimed to evaluate the cardiac safety of macrolides either used alone or co-administered with other agents.
METHODS: Pubmed and Embase databases were searched for the cardiac safety of macrolides in the treatment of infected patients. Identified studies were evaluated by two independent reviewers. Case reports, case series, controlled trials and randomly controlled trials were included.
RESULTS: A total of 48 reports (18 clinical studies and 30 case reports) were included in the present study. Among these reports, 25 were about macrolides used alone, and 23 about combination therapy. Based on the available data, we found that erythromycin carries the greatest risk of QT prolongation and Tdp from all macrolides in clinical practice (21/48), followed by clarithromycin (12/48) and azithromycin (6/48). Old age, high dosage, rapid administration and cardiac related diseases are additional risk factors.
CONCLUSIONS: Macrolides may induce cardiotoxicity themselves when used alone. When co-administered, they may also increase the risk of other drugs that potentially prolong the QTc interval or induce Tdp. Therefore, early and correct adjustment of the dosage, close daily ECG monitoring and the avoidance of co-administration of other known QT-prolonging agents should be used in order to prevent the development of adverse effects.
Daihong Guo; Yun Cai; Dong Chai; Beibei Liang; Nan Bai; Rui Wang
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  Die Pharmazie     Volume:  65     ISSN:  0031-7144     ISO Abbreviation:  Pharmazie     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9800766     Medline TA:  Pharmazie     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  631-40     Citation Subset:  IM    
Department of Clinical Pharmacology, PLA General Hospital, Beijing, People's Republic of China.
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MeSH Terms
Anti-Bacterial Agents / toxicity*
Drug Interactions
Heart Diseases / chemically induced*
Macrolides / toxicity*
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Macrolides

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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