Could Certain Antibiotics Increase Cardiovascular Risk?

The use of macrolide antibiotics is associated with increased risk of sudden cardiac death (SCD) and ventricular tachyarrhythmia (VTA), as well as all-cause mortality, according to a recent study.

Previous studies have provided conflicting evidence as to the relationship between macrolide antibiotics and cardiovascular events.
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In order to further examine this potential relationship, researchers conducted a meta-analysis of 33 studies involving 20,779,963 participants. Studies dated from between 1966 and 2015.

Overall, patients taking macrolides experienced increased risk of SCD or VTA (RR: 2.42; 95% CI: 1.61 to 3.63), SCD (RR: 2.52; 95% CI: 1.91 to 3.31), and cardiovascular death (RR: 1.31; 95% CI: 1.06 to 1.62).

No association was found between the use of macrolide antibiotics and all-cause mortality or other cardiovascular events.

Relative risk associated with SCD or VTA were 3.40 for azithromycin, 2.16 for clarithromycin, and 3.61 for erythromycin, and no risk was associated with roxithromycin use.

“Treatment with macrolides is associated with an absolute risk increase of 118.1 additional SCDs or VTA, and 38.2 additional cardiovascular deaths per 1 million treatment courses,” they concluded.

—Michael Potts

Reference:

Cheng Y, Nie X, Chen X, et al. The role of macrolide antibiotics in increasing cardiovascular risk. J Am Coll Cardiol. 2015;66(20):2173-2184.