Hypotension associated with azithromycin infusion in children with heart failure: a case report

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Pharmacology

Background:

• Azithromycin is a commonly used antibiotic for various infections.
• Mycoplasma myocarditis is an inflammation of the heart muscle in children, potentially caused by Mycoplasma bacteria.
• Acute, decompensated heart failure indicates a severe weakening of the heart's ability to pump blood effectively.

Observation:

• Two pediatric cases experienced acute hypotension (sudden drop in blood pressure) immediately following intravenous azithromycin administration.
• Both children had acute, decompensated heart failure and were being treated for suspected Mycoplasma myocarditis.

Findings:

• Hypotension is identified as a potentially rare adverse reaction to intravenous azithromycin in pediatric patients.
• The observed adverse event occurred in the context of treating Mycoplasma myocarditis in children with pre-existing cardiac dysfunction.

Implications:

• Clinicians should exercise caution when administering intravenous azithromycin to pediatric patients with cardiac dysfunction.
• Further research is warranted to understand the mechanism and incidence of azithromycin-induced hypotension in this vulnerable population.
• This finding highlights the importance of vigilant કાર્ડiac monitoring during antibiotic therapy in critically ill children.