AZITHROMYCIN AND ITS RISK OF SUDDEN CARDIAC DEATH- A SYSTEMIC REVIEW
With its broad antibiotic spectrum and perceived favourable safety profile, Azithromycin has become one of the top 15 most prescribed drugs and the best-selling antibiotic used to treat or prevent a range of common bacterial infections. It does not interfere with the array of commonly used medications that undergo CYP3A4 metabolism, because it neither undergoes CYP3A4 metabolism nor inhibits CYP3A4 to any clinically meaningful degree. In- vitro, azithromycin shows only limited blockade of the potassium channel hERG. This channel is critically involved in cardiomyocyte repolarization, and if it is blocked or otherwise malfunctioning, the result can be a prolonged QT interval, ventricular arrhythmias, and even sudden cardiac death. It is important to remember that macrolide antibiotic drugs differ substantially in the number of prescriptions written for them, with azithromycin being prescribed more often. Previous findings should prompt physicians to carefully reassess the risks and benefits of azithromycin use in their clinical practices. Hence, with careful consideration of modifiable and non-modifiable risk factors, as well as a little extra caution when prescribing potential QT-prolonging medications such as azithromycin, the clinical benefit of these often-advantageous medications can be maximized and the incidence of these tragic but rare drug-induced sudden cardiac deaths can be reduced.