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Clarithromycin induced torsade de pointes.

C Hensey1, D Keane

  • 1Department of Cardiology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. conorhensey@gmail.com

Irish Journal of Medical Science
|July 10, 2007
PubMed
Summary
This summary is machine-generated.

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Clarithromycin, a macrolide antibiotic, can cause QT prolongation, increasing the risk of torsade de pointes. This case highlights the importance of recognizing drug-induced arrhythmias, especially in susceptible patients.

Area of Science:

  • Pharmacology
  • Cardiology
  • Clinical Medicine

Background:

  • Clarithromycin is a widely prescribed macrolide antibiotic.
  • Macrolide antibiotics, including clarithromycin, are known to induce QT interval prolongation.
  • QT prolongation is a significant risk factor for potentially fatal ventricular arrhythmias like torsade de pointes.

Observation:

  • A 79-year-old female patient experienced recurrent episodes of torsade de pointes.
  • The arrhythmia episodes were temporally associated with the initiation of clarithromycin therapy.
  • Electrocardiographic monitoring revealed a marked QT interval prolongation during clarithromycin treatment.

Findings:

  • The patient's torsade de pointes episodes resolved after discontinuation of clarithromycin.

Related Experiment Videos

  • The findings support a causal relationship between clarithromycin and drug-induced QT prolongation.
  • This case underscores the proarrhythmic potential of clarithromycin.

    • Implications:

    • Clinicians must be aware of the potential for clarithromycin to cause QT prolongation and torsade de pointes.
    • Careful patient selection and monitoring are crucial when prescribing clarithromycin, particularly in individuals with pre-existing risk factors for arrhythmias.
    • Awareness of drug-induced QT prolongation is vital for preventing sudden cardiac death in susceptible populations, including those with congenital long QT syndrome.