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Clarithromycin-induced ventricular tachycardia
S Kundu1, S R Williams, S P Nordt
1Department of Family Medicine, University of California at San Diego, USA.
Abstract:
Clarithromycin is a relatively new macrolide antibiotic that offers twice-daily dosing. It differs from erythromycin only in the methylation of the hydroxyl group at position 6. Although the side-effect profile of erythromycin is established, including gastroenteritis and interactions with other drugs subject to hepatic mixed-function oxidase metabolism, experience with the newer macrolides is still being recorded. Cardiotoxicity has been demonstrated after both intravenous and oral administration of erythromycin but has never been reported with the newer macrolides. We report a case of ventricular dysrhythmias that occurred after six therapeutic doses of clarithromycin. The dysrhythmias resolved after discontinuation of the drug.
Insights
Clarithromycin, a macrolide antibiotic, may cause ventricular dysrhythmias. This case report details cardiac events in a patient after clarithromycin use, highlighting potential risks of this antibiotic.
Area of Science:
- Pharmacology
- Cardiology
- Infectious Diseases
Background:
- Clarithromycin is a widely used macrolide antibiotic known for its twice-daily dosing regimen.
- While erythromycin's side-effect profile is documented, including cardiotoxicity, data on newer macrolides like clarithromycin is still emerging.
- Cardiotoxicity has been associated with erythromycin but not previously reported with newer macrolides.
Observation:
- A patient developed ventricular dysrhythmias after receiving six therapeutic doses of clarithromycin.
- The cardiac adverse events were observed during clarithromycin treatment.
Findings:
- The reported case suggests a potential link between clarithromycin administration and the occurrence of ventricular dysrhythmias.
- These dysrhythmias resolved upon cessation of clarithromycin therapy.
Implications:
- This case highlights the importance of monitoring for cardiac side effects, even with newer antibiotics.
- Further investigation into the cardiotoxic potential of clarithromycin may be warranted.
- Clinicians should be aware of potential cardiac risks associated with clarithromycin use.