The DOI matches its Crossref record; 89 of the 89 references it cites were found in a registry or an index.
Macrolide Antibiotics and the Risk of Cardiac Arrhythmias
Open accessAbstract
Randomized, controlled trials have demonstrated that chronic therapy with macrolide antibiotics reduces the morbidity of patients with cystic fibrosis, non-cystic fibrosis bronchiectasis, chronic obstructive pulmonary disease, and nontuberculous mycobacterial infections. Lower levels of evidence indicate that chronic macrolides are also effective in treating patients with panbronchiolitis, bronchiolitis obliterans, and rejection after lung transplant. Macrolides are known to cause torsade des pointes and other ventricular arrhythmias, and a recent observational study prompted the FDA to strengthen the Warnings and Precautions section of azithromycin drug labels. This summary describes the electrophysiological effects of macrolides, reviews literature indicating that the large majority of subjects experiencing cardiac arrhythmias from macrolides have coexisting risk factors and that the incidence of arrhythmias in absence of coexisting risk factors is very low, examines recently published studies describing the relative risk of arrhythmias from macrolides, and concludes that this risk has been overestimated and suggests an approach to patient evaluation that should reduce the relative risk and the incidence of arrhythmias to the point that chronic macrolides can be used safely in the majority of subjects for whom they are recommended.
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“Several approved therapeutics, especially macrolide antibiotics and antihistamines/decongestants, have been associated with syncopal episodes (708).”
From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [708]
Citations
Cites
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Research works printed but not linked: 1
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Gibson, P. G., Yang, I. A., Upham, J. W., Reynolds, P. N., Hodge, S. J., James, A. L., Jenkins, C. R., Peters, M. J., Marks, G. B., Baraket, M., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)31281-3 · Cited by 685
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Heart Rhythm · doi:10.1016/j.hrthm.2017.03.004 · Cited by 478
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000499 · Cited by 463
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000498 · Cited by 411
2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope
Shen, W.-K., Sheldon, R. S., Benditt, D. G., Cohen, M. I., Forman, D. E., Goldberger, Z. D., Grubb, B. P., Hamdan, M. H., Krahn, A. D., Link, M. S., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.03.003 · Cited by 327
Metadata
- Authors
- Albert, R. K., & Schuller, J. L.
- Affiliations
- Denver Health Medical Center (US)
- Corresponding author
- Albert, Richard K.
- ORCID
- Albert, Richard K.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-05
- Volume
- 189
- Issue
- 10
- Pages
- 1173-1180
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- PMC
- PMC4061901
- OpenAlex
- W2134495308
- Cited by
- 163
- References
- 89
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 9 · 2023: 7 · 2022: 12 · 2021: 8 · 2020: 23 · 2019: 15 · 2018: 12 · 2017: 17 · 2016: 8 · 2015: 22 · 2014: 7
- FWCI
- 2.90
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Keywords
- macrolide antibiotics, cardiac arrhythmias, torsades de pointes, ventricular arrhythmias, azithromycin, drug safety, risk factors, cystic fibrosis, non-cystic fibrosis bronchiectasis, chronic obstructive pulmonary disease, nontuberculous mycobacterial infection, lung transplant rejection, bronchiolitis obliterans, electrophysiological effects
- MeSH terms
- Anti-Bacterial Agents, Arrhythmias, Cardiac, Cystic Fibrosis, Heart Conduction System, Humans, Risk Factors, Randomized Controlled Trials as Topic, Azithromycin, Macrolides, Pulmonary Disease, Chronic Obstructive
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