Another study has demonstrated that the commonly used antibiotics azithromycin and levofloxacin raised the risk of arrhythmia and death when compared to amoxicillin. In a retrospective cohort study of 1.8 million U.S. veterans (mean age 56.8 years), antibiotic use was linked to death rate and serious arrhythmias. The average use of azithromycin was 5 days, while levofloxacin and amoxicillin were generally used for 10 days. Azithromycin was associated with a hazard ratio for death of 1.48 (95% CI, 1.05-2.09) and serious arrhythmia 1.77 (95% CI, 1.20-2.62) compared to amoxicillin users. The hazard ratios for levofloxacin were 2.49 for death (95% CI, 1.7-3.62) and 2.43 for serious arrhythmia (95% CI, 1.56-3.79). The higher rates of events dropped off quickly after the drugs were discontinued (Ann Fam Med2014;12:121-127). The FDA issued a warning regarding azithromycin and fatal heart arrhythmias in May 2013. The risk for levofloxacin may be just as significant.
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