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Cardiovascular safety of macrolide and fluoroquinolone antibiotics: An analysis of the WHO database of adverse drug reactions
Author(s) -
Bonaldo Giulia,
Andriani Luisa Anna,
D'Annibali Ottavio,
Motola Domenico,
Vaccheri Alberto
Publication year - 2019
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.4873
Subject(s) - medicine , moxifloxacin , azithromycin , clarithromycin , levofloxacin , pharmacovigilance , pharmacoepidemiology , adverse drug reaction , adverse effect , pharmacology , intensive care medicine , drug , antibiotics , medical prescription , microbiology and biotechnology , biology , helicobacter pylori
The cardiovascular safety profile of macrolides and fluoroquinolones has been widely discussed. The aim of the present study is to provide the contribution of real‐world data onto the ongoing discussion about cardiovascular toxicity of both macrolides and fluoroquinolones. Methods Reports of adverse drug reactions (ADRs) were retrieved from VigiBase. Macrolides and fluoroquinolones were compared with amoxicillin by using the reporting odds ratio (ROR) as a measure of disproportionality. Macrolides were then compared with fluoroquinolones. Results Overall, 6810 reports of ADRs were retrieved: 62% of them were serious and 35% concerned female. Macrolides were more frequently associated with “atrial fibrillation” (ROR = 1.26, CI 1.02‐1.57) and “ventricular fibrillation” ROR = 2.60, CI 1.92‐3.54) than fluoroquinolones. Antimicrobials more frequently reported for “cardiac disorder” were azithromycin (375 reports) and clarithromycin (302) for macrolides and levofloxacin (470) and moxifloxacin (391) for fluoroquinolones. Conclusion Our data highlighted that macrolides and fluoroquinolones may influence cardiac rhythm and suggest caution in the prescribing of these drugs to patients with hidden cardiovascular risk factors. Although these ADRs seem to be not common, they have a notable impact in clinical practice because of the huge number of the exposed subjects.