“Healthcare professionals should consider the risk of fatal heart rhythms with azithromycin when considering treatment options for patients who are already at risk for cardiovascular events,” the FDA wrote. “FDA notes that the potential risk of QT prolongation with azithromycin should be placed in appropriate context when choosing an antibacterial drug.”
Other drugs in the macrolide class, as well as non-macrolide medications like fluoroquinolones, also have the potential to prolong the QT interval, the agency said, and those risks should be taken into account when mapping out a patient’s drug regimen.
Right now, azithromycin is FDA-approved for acute bacterial sinusitis, community-acquired pneumonia, bacterial exacerbations of chronic obstructive pulmonary disease, pharyngitis, skin infections, urethritis and genital ulcer disease, among other conditions. Patients at a particular risk for arrhythmias include those with known prolongation of the QT interval or those taking other drugs that could prolong the QT interval, as well as patients with ongoing proarrhythmic conditions like uncorrected hypokalemia, hypomagnesemia and clinically significant bradycardia.
As with any medication, the FDA recommended patients continue taking azithromycin until their physician clears them for an alternative.