Azithromycin Use Associated with Early Increased Risk for CV Death

Outpatient exposure to oral azithromycin was associated with an increased risk for cardiovascular death soon after exposure, according to a JAMA Network Open study.

Supported by the drugmaker, researchers retrospectively compared outcomes in some 3 million patients prescribed either azithromycin or amoxicillin (amoxicillin is not known to increase cardiovascular risk).

Some 15 years’ worth of data showed a heightened risk for cardiovascular death (but not sudden cardiac death) within 5 days of exposure (36 vs. 16 cardiovascular deaths per 1 million prescriptions). The adjusted hazard ratio for azithromycin, compared with amoxicillin, was 1.82, with a confidence interval spanning 1.23 to 2.67. The increase was not apparent for days 6 through 10.

For patients in the highest decile of cardiovascular risk, the risk for CV death was similarly elevated.

The authors conclude: “Although these analyses cannot establish causality, prescribers should be aware of this potential association.”