Common Antibiotic Not Linked to Serious Arrhythmia

Oral fluoroquinolone, commonly used in the treatment of febrile urinary tract and lower respiratory tract infections, are not associated with increased risk of serious arrhythmia, according to a recent study.

While no previous clinical trials have supported the potential association, several observational studies have suggested a possible relationship between fluoroquinolone and arrhythmia.
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To further explore this issue, researchers conducted a bi-national cohort study of Danish and Swedish adults, including data on 909,656 courses of fluoroquinolone and 909,656 courses of penicillin V.

Overall, 144 serious arrhythmias occurred, 66 among fluoroquinolone users and 78 among penicillin users. Compared with penicillin V, the absolute risk difference was –13 cases of arrhythmia per 1,000,000 courses of fluoroquinolone.

“Contrary to previous reports, oral fluoroquinolone treatment was not associated with an increased risk of serious arrhythmia in the general adult populations of Denmark and Sweden,” they concluded.

“Given the statistical power of the study, even small increases in relative and absolute risk could be ruled out. Since ciprofloxacin was the most commonly used fluoroquinolone in our study, we cannot exclude that intraclass differences influence the risk of serious arrhythmia associated with other less frequently used fluoroquinolones.”

—Michael Potts

Reference:
Inghammar M, Svanstrom H, Melbye M, et al. Oral fluoroquinolone use and serious arrhythmia: bi-national cohort study. BMJ. 2016;352:i843.