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2017, Number 4

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Rev Cubana Cardiol Cir Cardiovasc 2017; 23 (4)

Negative inotropic action and QT prolongation by azithromycin

Galán ML, Calderín PAD, Fleites VA

Language: Spanish
References: 31
Page:
PDF size: 387.85 Kb.


ABSTRACT

Introduction: Azithromycin is a macrolide antibiotic among the most consumed globally. In clinical practice, several cases of cardiac arrhythmias and prolongation of the QT interval associated with the use of azithromycin have been reported. However, there is little evidence of other possible adverse cardiac effects of this antibiotic. Objectives: To evaluate the actions of the antibiotic azithromycin on electrical and contractile activities in isolated rat hearts. Method: Electrical and contractile activities were recorded in isolated rat hearts perfused with the Langendorff technique.The effects of azithromycin (1 – 300 μmol/L, n = 6) were measured on the force of cardiac contraction and on the parameters RR, QRS and QTc of the electrocardiogram. Results: This antibiotic significantly prolonged the QTc interval, although it had no effect on the RR and QRS parameters. Azithromycin decreased the amplitude of the contraction force of all hearts studied, in a concentration-dependent manner. The estimated IC 50 was 51.9 ± 14 μmol. Conclusions: The effects of azithromycin on the QT interval explain the arrhythmogenic reports of this antibiotic in the clinic. The negative inotropic effect produced by azithromycin can be explained by its inhibitory action on cardiac calcium channels.


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