Azithromycin linked with adverse cardiovascular outcomes

The association between azithromycin and adverse cardiovascular events has prompted researchers in the United States to undertake a large community-based cohort study for further investigation. To compare the short-term risk of cardiovascular death and sudden cardiac death between azithromycin and amoxicillin, 7,824,681 antibiotic exposures in 2,929,008 patients were analysed (azithromycin exposures: 22.2%, amoxicillin exposures: 77.8%, mean age: 50.7 years). Within 5 days of exposure, azithromycin was significantly associated with a higher risk for cardiovascular death (hazard ratio [HR]: 1.82, 95% CI: 1.23-2.67), non-cardiovascular death (HR: 2.17, 95% CI: 1.44-3.26) and all-cause mortality (HR: 2.00, 95% CI: 1.51-2.63), but not for sudden cardiac death. These findings suggest that outpatient prescribing of azithromycin require considerable caution in light of a significant association with adverse cardiovascular outcomes. The full details can be viewed here.