Azithromycin, Levofloxacin Linked to Increased Risks for Arrhythmia

Azithromycin (Zpack) and levofloxacin (Levaquin) carry higher arrhythmia and mortality 
risks than amoxicillin, according to an observational study in the 
Annals of Family Medicine. The FDA issued a cardiac warning on 
azithromycin in March 2013.

Researchers studied nearly 1.8 million U.S. veterans (mean age, 57) 
who received outpatient prescriptions for one of the three antibiotics 
from 1999 to 2012. On weighted analysis, the numbers of deaths by day 
5 of treatment per million antibiotics dispensed were 154 for 
amoxicillin, 228 for azithromycin, and 384 for levofloxacin. Patients 
receiving azithromycin had roughly a 50% increased risk for death and 
an 80% increased risk for serious arrhythmia, compared with those on 
amoxicillin. Risk increases were even greater for levofloxacin.

The researchers conclude: “There are usually multiple antibiotic 
choices available for older patients, especially those with cardiac 
comorbidities; physicians may consider prescribing medications other 
than azithromycin and levofloxacin.”

Annals of Family Medicine article

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s