Antibiotics are among the most frequently prescribed medications in modern medicine. Antibiotics cure disease by killing or injuring bacteria. The first antibiotic was penicillin, discovered accidentally from a mold culture. Today, over 100 different antibiotics are available to cure minor, as well as life-threatening infections. Although antibiotics are useful in a wide variety of infections, it is important to realize that antibiotics only treat bacterial infections.
Recently, researchers have been going back to study “time-tested” drugs only find inherent risk. For instance, a common heart drug always believed to be inherently safe is now believed to increase cardiac death. Some antibiotics were recently shown to alter immunity and lead to respiratory disease susceptibility later on.
Clarithromycin, a common antibiotic – lauded by WHO and used for wide variety of infections like gastritis, skin, lung, throat and lyme – can now be added to the list.
So the team decided to assess the risk of cardiac death associated with clarithromycin and another macrolide called roxithromycin – they compared it with penicillin V, an antibiotic with no known cardiac risk.
Using national databases, they identified over 5 million treatment courses among Danish adults aged 40-74 years from 1997 to 2011 (160,297 with clarithromycin, 588,988 with roxithromycin and 4,355,309 with penicillin V). Excluded from the …
Our study expands on the available knowledge of the cardiac safety of macrolides, being the first large scale population based observational study to show significantly increased cardiac risk with clarithromycin and the relative cardiac safety of roxithromycin.
clarithromycin is one of the more commonly used antibiotics in many countries and many millions of people are prescribed this drug each year; thus, the total number of excess (potentially avoidable) cardiac deaths may not be negligible.
They stress that the absolute risk is small but conclude that, before these results are used to guide clinical decision making:
…confirmation in independent populations is an urgent priority given the widespread use of macrolide antibiotics.
While the risk of cardiac death may sound small, there are other side effects to clarithromycin like vomiting, diarrhea, insomnia and abnormal liver function. Here are many more side effects.
It’s important to realize that the researchers are not calling for clinicians to stop prescribing clarithromycin, but instead for more data from different populations of patients, to see whether or not their finding can be confirmed. They have good reasons for that cautious conclusion.
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