Antibiotics: Macrolide Antibiotics Don't Increase The Risk Of Heart Problems

In 2013, the Food and Drug Administration (FDA) issued a warning against the use of common macrolide antibiotics--claiming that they could increase the risk of a serious heart rhythm disturbance (ventricular arrhythmia) and death.

Now, new findings presented by Canadian researchers show that macrolide antibiotics, including azithromycin, clarithromycin and erythromycin, no further increase these risks than nonmacrolide antibiotics.

"We observed that, compared with nonmacrolide antibiotics, new use of macrolide antibiotics was associated with a similar 30-day risk of ventricular arrhythmia ... and a slightly lower risk of all-cause mortality," wrote Dr. Amit Garg, director of the ICES western facility in London, Ontario, a physician at London Health Sciences Centre and a researcher at Lawson Health Research Institute, according to a news release. 

During the study, researchers conducted a study of over 600,000 adults aged 65 years and older in Canada's largest province, Ontario. The researchers examined data from the Institue for Clinical Evaluative Sciences (ICES) and universal prescription drug coverage data from the Ontario Health Insurance Plan (OHIP). Then, they matched people taking macrolide antibiotics with those of similar age and health. The majority of participants in the study were also women, at 57 percent.

No higher risk of adverse events with macrolide antibiotics compared to nonmacrolide antibiotics was observed in subsets of patients with congestive heart failure, coronary artery disease and chronic kidney disease.

"In contrast to prior studies, we found that these variables did not significantly alter the association between macrolide antibiotic use and our outcomes. Nonetheless, these findings should be interpreted with caution, and physicians should always consider a patient's baseline risk for adverse events before prescribing macrolides or other antibiotics."

"These findings are reassuring for health care providers who prescribe macrolide antibiotics to a wide range of patients in routine care," they concluded.

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