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Cardiac Arrest in Pediatric Patients Receiving Azithromycin
Santiago O Valdés1, Jeffrey J Kim1, Mary C Niu2
1Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
The Journal of Pediatrics
|December 4, 2016
Summary
Azithromycin use in pediatric pneumonia patients showed no increased risk of cardiac arrest compared to penicillin or cephalosporin. This study found no association between macrolide antibiotics and cardiac events in children.
Area of Science:
- Pediatric pharmacology
- Infectious disease epidemiology
- Cardiovascular safety
Background:
- Azithromycin is a commonly prescribed antibiotic for pediatric community-acquired pneumonia.
- Concerns regarding cardiac safety of azithromycin have been raised based on adult studies.
- Limited data exists on the cardiac safety of azithromycin in pediatric populations.
Purpose of the Study:
- To compare the outcomes of pediatric patients treated with azithromycin versus penicillin or cephalosporin.
- To investigate the association between azithromycin use and cardiac mortality or arrest in children.
- To evaluate the incidence of ventricular arrhythmias and readmissions for these events.
Main Methods:
- Retrospective cohort study utilizing the Pediatric Health Information System database (2008-2012).
- Inclusion criteria: Patients <19 years with community-acquired pneumonia treated with antibiotics.
- Primary outcomes: Cardiopulmonary resuscitation (CPR) and mortality; Secondary outcomes: Ventricular arrhythmias and related readmissions.
Main Results:
- A total of 82,982 pediatric patients were analyzed.
- Azithromycin was used in 6.1% of patients; penicillin/cephalosporin in 93.9%.
- Patients receiving azithromycin had a lower prevalence of CPR (0.04% vs 0.14%, P=.04) and no difference in mortality compared to those on penicillin/cephalosporin.
Conclusions:
- Azithromycin use in pediatric patients hospitalized for community-acquired pneumonia is not associated with an increased prevalence of cardiac arrest.
- Findings contrast with some adult studies, suggesting a potentially different safety profile in pediatric populations.
- No association was found between macrolide use and CPR in multivariable analysis.
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