Related Experiment Video

Updated: Aug 7, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
11:17

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses

Published on: August 30, 2018

13.0K

Administration of macrolide antibiotics increases cardiovascular risk

Yang Wu1,2, Wen-Tao Bi1,2, Li-Ping Qu1

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

Frontiers in Cardiovascular Medicine
|March 13, 2023
PubMed
Abstract

Insights

Macrolide antibiotics increase the risk of sudden cardiac death (SCD) and cardiovascular death, but not all-cause mortality. Timing of macrolide use impacts cardiac risk, with recent use linked to SCD/ventricular tachycardia.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • The cardiovascular risks associated with macrolide antibiotics have been debated for decades.
  • Understanding these risks is crucial for patient safety and clinical decision-making.

Purpose of the Study:

  • To investigate the association between macrolide antibiotic use and cardiovascular risk.
  • To analyze the impact of macrolide administration timing on cardiac events.

Main Methods:

  • A comprehensive meta-analysis of 80 studies involving over 39 million patients.
  • Searched Medline, EMBASE, and ClinicalTrials.gov databases up to August 31, 2022.
  • Utilized a random-effects model for data synthesis.

Main Results:

  • Macrolides were not associated with all-cause mortality.
  • Significant increased risk of ventricular arrhythmia or sudden cardiac death (VA or SCD) with azithromycin and clarithromycin.
  • Increased risk of cardiovascular disease (CVD) death and myocardial infarction (MI) with azithromycin.
  • Roxithromycin showed no association with adverse cardiac outcomes.
  • Recent macrolide use correlated with VA/SCD; former use with MI; current use with CVD death.

Conclusions:

  • Macrolide antibiotic administration is linked to elevated risks of SCD/ventricular tachycardia and cardiovascular death.
  • The timing of macrolide use influences specific cardiovascular risks.
  • No increased risk of all-cause mortality was observed.
Keywords:
cardiovascular riskmacrolide antibioticsmeta-analysissudden cardiac deathventricular arrhythmia

More Related Videos

Author Spotlight: Scalable Drug Screening Protocol for Efficient Discovery of M. abscessus Treatments07:50

Author Spotlight: Scalable Drug Screening Protocol for Efficient Discovery of M. abscessus Treatments

Published on: October 25, 2024

1.8K
Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS08:38

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

17.0K

Related Concept Videos

Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
11
Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
607
Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.5K
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
802
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers01:20

Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers

Class IV antiarrhythmic drugs, such as verapamil and diltiazem, block calcium channels. They primarily affect the heart, slowing the conduction in calcium-dependent tissues like the SA and AV nodes. These drugs manage reentrant supraventricular tachycardia (SVT) and reduce ventricular rate in atrial flutter/fibrillation.
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
918
Lipid-Lowering Drugs: Statins and Miscellaneous Agents01:20

Lipid-Lowering Drugs: Statins and Miscellaneous Agents

Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
726