-- Robert Preidt
TUESDAY, Aug. 19, 2014 (HealthDay News) -- Taking the widely
used antibiotic clarithromycin may boost some patients' odds of
dying from heart-related causes, a new study suggests.
Because millions of people receive this antibiotic each year,
the findings require urgent confirmation, said the Danish
researchers behind the study. However, they emphasized that the
actual risk is small and that guidelines for the use of the drug
should not be changed until more information is available.
One heart expert wasn't surprised by the finding, however.
"Some commonly used antibiotics should be taken with caution, especially for those people who are at risk for heart disease," said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City.
"As it has been shown before, not all antibiotics are created equal when it comes to increasing the risk of cardiovascular death," she said. "If you have an underlying heart condition, be certain to discuss it with your doctor before taking an antibiotic prescription. There are definitely safer alternatives."
Clarithromycin and another antibiotic called roxithromycin
belong to a group of antibiotics called macrolides. It's believed
that macrolides increase the risk of potentially deadly heart
rhythm problems, the Danish researchers explained.
In the study, they analyzed more than 5 million courses of
antibiotic treatment with clarithromycin, roxithromycin, or
penicillin V given to Danish adults, aged 40 to 74, between 1997
During this period, 285 cardiac deaths occurred -- 18 during the
use of clarithromycin and 32 during the use of roxithromycin. After
adjusting for other factors, the researchers concluded that ongoing
use of clarithromycin was associated with a 76 percent higher risk
of cardiac death, compared with the use of penicillin V.
The absolute risk difference was 37 cardiac deaths per 1 million
courses with clarithromycin. The authors noted that there was no
heightened risk of cardiac death after treatment with
Ongoing or past use of roxithromycin was not associated with
increased risk of cardiac death, according to the study published
online Aug. 19 in
The study is "the first large-scale population-based
observational study to show significantly increased cardiac risk
with clarithromycin and the relative cardiac safety of
roxithromycin," wrote a team led by Henrik Svanstrom of the Statens
Serum Institut in Copenhagen.
Because the study was observational in nature (looking over past
data), it could not prove a cause-and-effect relationship. However,
an expert familiar with antibiotics said the findings are worthy of
Although the risk to any one patient remains very small, "it
should still be considered by physicians before prescribing this
antibiotic," said Dr. Ambreen Khalil, an infectious disease
specialist at Staten Island University Hospital in New York City.
"Patients with underlying heart conditions who are taking
medications that affect the heart rhythm may be particularly
vulnerable," she said.
The U.S. National Library of Medicine has more about
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