Does Azithromycin Raise Risk for Cardiovascular-Related Death?

Several macrolide antibiotics have proarrhythmic effects, but azithromycin is thought to be less cardiotoxic than others. Researchers at Vanderbilt University investigated this assumption using Medicaid records for 402,260 patients. They monitored deaths from heart disease and other causes during 3.3 million 5-day windows during which some patients received azithromycin and other clinically similar patients did not take antibiotics, or took amoxicillin, ciprofloxacin, or levofloxacin.

Patients who took azithromycin had significantly elevated rates of cardiovascular-related death compared with people in each of the control groups (except the levofloxacin group). For example, compared with patients who took no antibiotics or amoxicillin, patie…