Effects of Azithromycin on Cardiac Deaths, Article Review Example

Ray et al (2012, 366) analyzes the strategy of antibiotic azithromycin within the prescription period in patients who were not at risk of death from other ailments. He compares it with the procedure employed in other commonly used antibiotics. This analysis hypothesized that the use of azithromycin on the study group led to cardiac arrhythmia and higher incidence of death in patients who did not use the drug or those who used other antibiotics. The end point of the research was mortality, which was a result of cardiovascular accidents. The study group comprised of 347,795 individuals with azithromycin prescriptions, a matched control group of 1,391,180 persons with no anti biotic treatment, 1,348,672 persons with prescriptions for amoxicillin, 264,626 with prescriptions for ciprofloxacin, and 193,906 prescriptions for levofloxacin (all antibiotics suspected to affect the cardiac rhythms).

Azithromycin users ranged from 34 to 75 years of age (with a mean of 49 years) in the trace period from 1992 to 2006. Though all the antibiotic drugs under study were attributed to increased risk of cardiovascular deaths and deaths from other causes, the researchers found that the use of azithromycin lead to an amplified possibility of deaths due to cardiovascular deaths than in patients who took either amoxicillin or ciprofloxacin within the 5 day study period, but had no significant difference with the risk of death in patients who took levofloxacin. Researchers found that patients who used azithromycin for 5 days (5 days is the prescription period for azithromycin) were at a higher risk of heart related deaths than the control group that did not take any antibiotics (85.2 deaths per 1 million for azithromycin vs. 29.2 deaths per 1 million patients for the control group). The researchers found that patients who used azithromycin had an estimated 47 deaths per 1 million patients within the 5 day period compared to amoxicillin. In addition, they found that there were 245 deaths per 1 million patients within the upper 10 % at risk of heart disease related deaths. Ray et al showed that azithromycin and levofloxacin had higher proarrythmiatic tendencies as compared to amoxicillin and ciprofloxacin.

Results of Specific Study

The results of this study are of significant importance to cardiologists, policy makers, general practitioners, diabetic’s experts and pharmacists because they are the persons who mostly use antibiotics. Azithromycin and amoxicillin are mostly prescribed for patients with ear, nose and throat infections as well as bronchitis while ciprofloxacin is frequently indicated for genitourinary tract infections. Patients who take ciprofloxacin are likely to have diabetes, get wheelchair bound or will have difficulties to control their bowels and bladders. Levofloxacin is usually prescribed for contaminations of the nose, ear, and throat and for other respiratory and genitourinary infections. The results of such a study are thus of importance to medical practitioners who are obliged to prescribe to them. A preponderance of medical consultants deal with older patients (older patients are more predisposed to cardiac diseases) or patients who are endangered by lifestyle diseases such as patients who have central obesity or dislipidemia.

The results of this specific study and Levofloxacin are also important for smokers and bed ridden patients who are at risk of respiratory diseases such as pneumonia. These results will affect the type of antibiotic I prescribe for patients with respiratory, ear, nose and throat indications who are within the higher risk group for cardiac deaths. I will prescribe antibiotics with lower risk incidence for these patients to reduce cardiac deaths. In such patients, amoxicillin and ciprofloxacin will put them at reduced risks as compared to azithromycin and levofloxacin. It is safer to use the less risky drug in cases of similar indications.

Reference

Ray WA, Murray KT, Hall K, Arbogast PG & Stein CM. (2012). Azithromycin and the Risk of Cardiovascular Death. New England Journal of Medicine, 366, 1881-1890.