Wednesday May 7, 2014 (foodconsumer.org) -- A study published in Annals of Family Medicine suggests that using antibiotics azithromycin and levofloxacin may increase risk of cardiac arrhythmia and death, compared with amoxicillin use.

The study was based on data from a cohort of US veterans at a mean age of 56.8 years, 979,380 treated with amoxicillin, 594,792 treated with azithromycin  and 201,798 treated with levofloxacin.  Treatment with azithromycin lasted five days while treatment with amoxicillin and levofloxacin lasted for at least ten days.

Compared with patients treated with antibiotic amoxicillin, those who received antibiotic azithromycin were 48% and 77% more likely to die and suffer serious arrhythmia, respectively, during the first five days of treatment. The risks were not increased during the 6th to 10th days of treatment.

Also, compared with patients treated with amoxicillin, patients treated with antibiotic levofloxacin for days 1 to 5 were 149% and 143% more likely to die and develop serious cardiac arrhythmia, respectively. 

And the risk remained higher during the 6th to 10th days of treatment, that is, compared with using amoxicillin, using antibiotic levofloxacin was associated with 95% and 75% increased risk for death and arrhythmia, respectively.

The researchers concluded "Compared with amoxicillin, azithromycin resulted in a statistically significant increase in mortality and arrhythmia risks on days 1 to 5, but not 6 to 10." 

They also concluded "Levofloxacin, which was predominantly dispensed for a minimum of 10 days, resulted in an increased risk throughout the 10-day period."

Gowtham A. Rao, MD, PhD, MPH at University of South Carolina in Columbia, SC and colleagues conducted the study.

According to the authors, use of antibiotic azithromycin has been found earlier correlated with elevated risk of death in patients at higher baseline risk, but not younger and middle-aged adults. 

All antibiotics have side effects and adverse effects.  Patients should get familiar with all side effects and adverse effects associated with antibiotics.  When they experience certain symptoms, patients are advised immediately to see medical attention. (David Liu)

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