Jiun-Ling Wang, MD, from National Taiwan University Hospital, Taipei, who investigated the association between macrolides and cardiac arrhythmias and mortality in a Taiwanese nationwide study, told Reuters Health by email, “We should use macrolides carefully, especially in patients with underlying heart disease or high risk of ventricular tachyarrhythmia such as concomitant drug user with QT prolonged potential or hypokalemia. If there is high risk of ventricular tachyarrhythmia, and cardiovascular death, an alternative antibiotic should be considered.”
Coauthor of that study, Chia-Hsuin Chang, MD, PhD, told Reuters Health by email, “Although currently it is still too early to conclude that the observed high risk is due to drug effect, related to the type of infectious disease, or underlying comorbidities, it is suggested that physicians should pay more attention to their potential cardiac toxicity, avoid unnecessary use of macrolides, and shift to beta-lactam antibiotics if possible.”
Three science programs in China supported this research. The authors reported no disclosures.
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