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The Role of Macrolide Antibiotics in Increasing Cardiovascular Risk

Yun-Jiu Cheng1, Xiao-Ying Nie2, Xu-Miao Chen1

  • 1Department of Cardiology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

Journal of the American College of Cardiology
|November 14, 2015
PubMed
Abstract

Insights

Macrolide antibiotics, commonly prescribed, are linked to a higher risk of serious cardiac events like sudden cardiac death (SCD) or ventricular tachyarrhythmias (VTA) and cardiovascular death. However, they do not appear to increase the risk of death from any cause.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Conflicting evidence exists from large cohort studies on the cardiac risks associated with oral macrolide antibiotics.
  • Serious cardiac events are a concern for patients prescribed macrolides.

Purpose of the Study:

  • To conduct a meta-analysis investigating the association between macrolide antibiotic use and the risk of sudden cardiac death (SCD) or ventricular tachyarrhythmias (VTA).
  • To evaluate the link between macrolides and cardiovascular death, and all-cause mortality.

Main Methods:

  • A comprehensive literature search was performed using MEDLINE and EMBASE databases.
  • Included studies reported relative risk (RR) estimates with 95% confidence intervals (CIs) for macrolide-associated cardiac events.

Main Results:

  • The meta-analysis included 33 studies with over 20 million participants.
  • Macrolide use was associated with increased risk of SCD/VTA (RR: 2.42) and cardiovascular death (RR: 1.31).
  • Specific macrolides like azithromycin, clarithromycin, and erythromycin showed increased risks, while roxithromycin did not.

Conclusions:

  • Macrolide antibiotic administration is associated with an elevated risk of SCD/VTA and cardiovascular death.
  • No significant association was found between macrolide use and all-cause mortality.
Keywords:
coronary heart diseaseroxithromycinsudden cardiac deathventricular tachyarrhythmia

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