SynthesisAntimicrobial agents and chemotherapy2018
Systematic Review, Meta-analysis, and Network Meta-analysis of the Cardiovascular Safety of Macrolides.
Synthesis in Antimicrobial agents and chemotherapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 5 syntheses or guidelines pooled it, 68 citations in OpenAlex.
- Comparing the clinical efficacy of COVID-19 vaccines: a systematic review and network meta-analysis.Scientific reports · 2021Pooled it
- Antibiotics for secondary prevention of coronary heart disease.The Cochrane database of systematic reviews · 2021Pooled it
- Prenatal Exposure to Macrolides and Risk of Congenital Malformations: A Meta-Analysis.Drug safety · 2020Pooled it
- Clarithromycin use and the risk of mortality and cardiovascular events: A systematic review and meta-analysis.PloS one · 2019Pooled it
- Azithromycin or erythromycin? Macrolides for non-cystic fibrosis bronchiectasis in adults: A systematic review and adjusted indirect treatment comparison.Chronic respiratory diseasePooled it
- Cardiotoxicity of macrolide antibiotics: a pharmacovigilance study integrating FAERS and JADER databases.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Safety Monitoring of High-Risk Antibiotics Using Artificial Intelligence: A Narrative Review with Focus on Real-World Evidence.Life (Basel, Switzerland) · 2026Review
- Cardiovascular Risk During the 90-Day Vulnerable Window After COPD Exacerbations: A Narrative Review.Life (Basel, Switzerland) · 2026Review
- Macrolide Antibiotic Mediated Cardiac Arrhythmias: Emerging Concepts and Clinical Implications.Biomedicines · 2025Review
- Pharmacologic treatments for gastroparesis.Pharmacological reviews · 2025Review
- Cardiovascular benefits and safety profile of macrolide maintenance therapy in patients with bronchiectasis.The European respiratory journal · 2025Article
- Cardiovascular Toxicity Profile of Macrolides Investigated Using VigiBase Data: A Pharmacovigilance Study.Cardiovascular toxicology · 2025Article
- Imaging in Gastroparesis: Exploring Innovative Diagnostic Approaches, Symptoms, and Treatment.Life (Basel, Switzerland) · 2023Review
- Ten controversies in gastroparesis and a look to the future.Neurogastroenterology and motility · 2023Review
- Administration of macrolide antibiotics increases cardiovascular risk.Frontiers in cardiovascular medicine · 2023Article
- A nationwide cohort study suggests clarithromycin-based therapy for Helicobacter pylori eradication is safe in patients with stable coronary heart disease and subsequent peptic ulcer disease.BMC gastroenterology · 2022Article
- Efficacy and safety of COVID-19 vaccines: A network meta-analysis.Journal of evidence-based medicine · 2022Article
- Comparative safety of inhaled corticosteroids and macrolides in Medicare enrolees with bronchiectasis.ERJ open research · 2022Article
- No dose-response relationship of clarithromycin utilization on cardiovascular outcomes in patients with stable coronary heart disease: Analysis of Taiwan's national health insurance claims data.Frontiers in cardiovascular medicine · 2022Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Studies reporting an increased risk for cardiac toxicities with macrolide antibiotics have raised concern regarding their cardiovascular safety. We sought to assess the cardiac safety of macrolide antibiotics as a class and of the individual agents by conducting a systematic review and network meta-analysis. Medline, Embase, and the Cochrane Library were searched up to February 2018 for studies reporting on cardiovascular outcomes with macrolides. We followed the PRISMA 2009 guidelines for data selection and extraction. Outcomes were pooled using random-effects models and odds ratios (OR), and 95% confidence intervals (CI) were calculated for arrhythmia, cardiovascular death, and myocardial infarction (MI). A total of 33 studies and data on 22,601,032 subjects were retrieved and included in the current meta-analyses. Macrolide use was not associated with the risk of arrhythmia or cardiovascular mortality. In the primary analysis, macrolide use was associated with a small but statistically significant 15% increase in risk for MI (OR = 1.15 [95% CI, 1.01 to 1.30]). In indirect network meta-analysis, erythromycin and clarithromycin were ranked considerably more likely to be associated with a higher risk for MI and significantly associated with increased risk of MI compared to azithromycin (OR = 1.58 [95% CI, 1.18 to 2.11] and OR = 1.41 [95% CI, 1.11 to 1.81], respectively). Our findings indicate that macrolide antibiotics as a group are associated with a significant risk for MI but not for arrhythmia and cardiovascular mortality. Among the macrolides, erythromycin and clarithromycin were associated with a greater risk of MI. However, it is possible that the association between macrolide use and risk of MI is the result of residual confounding.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.