RT Journal A1 Kuehn BM T1 CArdiovascular death risk linked to azithromycin use JF JAMA JO JAMA YR 2012 FD June 13 VO 307 IS 22 SP 2361 OP 2361 DO 10.1001/jama.2012.6421 UL http://dx.doi.org/10.1001/jama.2012.6421 AB The alert was prompted by the publication of a study that found a small increased risk of cardiovascular death during the course of therapy with azithromycin (Ray WA et al. N Engl J Med. 2012;366[20]:1881-1890). The researchers compared short-term cardiac death rates among 3 groups: 347 795 individuals enrolled in Tennessee Medicaid who received prescriptions for azithromycin, more than 1 million propensity-matched controls not taking an antibiotic, and more than 1 million individuals who received prescriptions for amoxicillin or another antibiotic. Compared with individuals who took no antibiotics, those who took azithromycin had an increased risk of cardiovascular death (hazard ratio, 2.88; 95% CI, 1.79-4.63). Individuals who took a 5-day course of azithromycin were also at elevated risk compared with those who took amoxicillin (hazard ratio, 2.49; 95% CI, 1.38-4.50). The authors estimate this would result in an additional 47 cardiovascular-related deaths per 1 million courses of azithromycin. They also said that the potential harm is even greater among patients who were already at elevated risk of cardiovascular adverse events, with azithromycin use associated with an estimated 245 cardiovascular deaths among such at-risk individuals.