Observational studyEuropean journal of clinical pharmacology2016
Drug safety of macrolide and quinolone antibiotics in a tertiary care hospital: administration of interacting co-medication and QT prolongation.
Observational study in European journal of clinical pharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 34 citations in OpenAlex.
- Current practices in antibiotic prophylaxis for patients on complement inhibitors: a multicenter survey across ERN ERKnet centers.Clinical kidney journal · 2026Article
- Drug-Drug Interactions in Recently Approved Antibacterials: A Mini Review.European journal of drug metabolism and pharmacokinetics · 2026Review
- Review
- Macrolide Therapy in Patients with Sepsis or Septic Shock: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Optimizing β-lactam-containing antibiotic combination therapy for the treatment of Buruli ulcer.British journal of clinical pharmacology · 2025Article
- Rapid changes of mRNA expressions of cardiac ion channels affected by Torsadogenic drugs influence susceptibility of rat hearts to arrhythmias induced by Beta-Adrenergic stimulation.Pharmacology research & perspectives · 2023Article
- Antibiotics and Lipid-Modifying Agents: Potential Drug-Drug Interactions and Their Clinical Implications.Pharmacy (Basel, Switzerland) · 2023Review
- The Issue of Pharmacokinetic-Driven Drug-Drug Interactions of Antibiotics: A Narrative Review.Antibiotics (Basel, Switzerland) · 2022Review
- Calculated parenteral initial therapy of bacterial infections: Antibiotic treatment in the elderly.GMS infectious diseases · 2020Article
- Impact of Drug Induced Long QT Syndrome: A Systematic Review.Journal of clinical medicine research · 2018Article
- Monotherapy of experimental metabolic syndrome: II. Study of cardiovascular effects.Interdisciplinary toxicology · 2017Article
- Survey about the use of clarithromycin in an ENT outpatient department of a tertiary hospital.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2017Article
- Targeted Cancer Therapies and QT Interval Prolongation: Unveiling the Mechanisms Underlying Arrhythmic Complications and the Need for Risk Stratification Strategies.Clinical drug investigation · 2017Review
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSome macrolide and quinolone antibiotics (MQABs) are associated with QT prolongation and life-threatening torsade de pointes (TdP) arrhythmia. MQAB may also inhibit cytochrome P450 isoenzymes and thereby cause pharmacokinetic drug interactions (DDIs). There is limited data on the frequency and management of such risks in clinical practice. We aimed to quantify co-administration of MQAB with interacting drugs and associated adverse drug reactions.
methodsWe conducted an observational study within our pharmacoepidemiological database derived from electronic medical records of a tertiary care hospital. Among all users of MQAB associated with TdP, we determined the prevalence of additional QT-prolonging drugs and risk factors and identified contraindicated co-administrations of simvastatin, atorvastatin, or tizanidine. Electrocardiographic (ECG) monitoring and associated adverse events were validated in medical records.
resultsAmong 3444 administered courses of clarithromycin, erythromycin, azithromycin, ciprofloxacin, levofloxacin, or moxifloxacin, there were 1332 (38.7 %) with concomitant use of additional QT-prolonging drugs. Among those, we identified seven cases of drug-related QT prolongation, but 49.1 % had no ECG monitoring. Of all MQAB users, 547 (15.9 %) had hypokalemia. Forty-four MQAB users had contraindicated co-administrations of simvastatin, atorvastatin, or tizanidine and three of those related adverse drug reactions.
conclusionIn the studied real-life setting, we found a considerable number of MQAB users with additional risk factors for TdP but no ECG monitoring. However, adverse drug reactions were rarely found, and costs vs. benefits of ECG monitoring have to be weighted. In contrast, avoidable risk factors and selected contraindicated pharmacokinetic interactions are clear targets for implementation as automated alerts in electronic prescribing systems.
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