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Evidence suggests clarithromycin use is associated with excess cardiovascular (CV) risk, but whether such risk is short-term or long-term is unclear. In this population-based study, investigators in Hong Kong compared CV outcomes among 109,000 adults who received oral clarithromycin with outcomes among 218,000 adults who received oral amoxicillin (which is not associated with CV risk). Patients were matched by age, sex, and calendar year of antibiotic use.
Propensity-adjusted analyses showed that, with current use, risk for myocardial infarction (MI) was 3.7 times higher and risk for arrhythmia was 2.2 times higher among clarithromycin users than among amoxicillin users. All-cause and cardiac-related mortality was roughly doubled among curre…