Journal Article

Antimicrobial-Associated QT Interval Prolongation: Pointes of Interest

Ellie J. C. Goldstein, Robert C. Owens and Thomas D. Nolin

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 43, issue 12, pages 1603-1611
Published in print December 2006 | ISSN: 1058-4838
Published online December 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/508873
Antimicrobial-Associated QT Interval Prolongation: Pointes of Interest

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Until recently, cardiac toxicity manifesting in the form of arrhythmias related to QT interval prolongation was uncommonly appreciated within the antimicrobial class of drugs, but it was well described among antiarrhythmic agents. Antimicrobials that are associated with QT prolongation include the macrolides/ketolides, certain fluoroquinolones and antimalarials, pentamidine, and the azole antifungals. Although, in most cases, mild delays in ventricular repolarization caused by these drugs are clinically unnoticable, they may serve to amplify the risk for torsades de pointes (TdP) when prescribed in the setting of other risk factors. Conditions or variables that influence proarrhythmic risk include sex, age, electrolyte derangements, structural heart disease, pharmacokinetic/pharmacodynamic interactions, and genetic predisposition. It is important that clinicians be knowledgable about drugs with QT liability, as well as the risk factors that increase the probability of TdP. Additionally, because TdP remains a difficult-to-measure adverse event, we must rely upon multiple data sources to determine the risk versus the benefit for newly approved drugs.

Journal Article.  5914 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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