Infectious Disease

CVD, non-CVD mortality elevated with azithromycin consumption

HealthDay News – According to a study published online June 17 on JAMA Network Open, outpatient use of azithromycin is associated with an increased risk of cardiovascular and non-cardiovascular mortality.

Jonathan G. Zaroff, MD of Kaiser Permanente in Northern California in Oakland and colleagues estimated the relative and absolute risk of cardiovascular and sudden cardiac death following an ambulatory prescription of azithromycin versus amoxicillin using data from two large, diverse, ambulatory integrated facility delivery systems . Data were included for 7,824,681 antibiotic exposures (22.2 and 77.8 percent azithromycin and amoxicillin, respectively) among 2,929,008 individuals.

The researchers found that azithromycin was associated with a significantly increased risk of cardiovascular death within five days of exposure (hazard ratio 1.82; 95 percent confidence interval 1.23 to 2.67), but not with sudden cardiac death (Hazard ratio 1.59; 95 percent confidence interval 0.90 to 2.81). No increase in risk was observed six to 10 days after exposure. The results were similar for patients in the upper decile of cardiovascular risk (hazard ratio 1.71; 95 percent confidence interval 1.06 to 2.76). Within five days of exposure, azithromycin was also associated with an increased risk of non-cardiovascular death (hazard ratio, 2.17; 95 percent confidence interval, 1.44 to 3.26) and all-cause mortality (hazard ratio, 2.00 ; 95 percent confidence interval, 1.51 to) connected 2.63).

“Although these analyzes cannot establish causality, prescribers should be aware of this possible association,” the authors write.

Two authors disclosed financial ties to the pharmaceutical industry; The study was funded by Pfizer.

Abstract / full text


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