A widely used antibiotic may increase the risk of heart problems in patients
with lung conditions, according to a new study.
The antibiotic clarithromycin is commonly used to treat lower respiratory
infections such as pneumonia and sudden worsening of chronic obstructive
pulmonary disease (COPD).
Previous research has suggested that the use of clarithromycin may increase
the risk of heart problems such as heart failure, heart rhythm disorders and
sudden cardiac death.
How the study was done
In this study, British researchers looked at data from about 1 300 patients
with sudden worsening of COPD and about 1 600 patients with pneumonia.
They found that 26% of the COPD patients who received clarithromycin
experienced at least one heart problem over the next year, compared with 18
percent of those who were not given the antibiotic.
12% of pneumonia patients who received clarithromycin experienced at least
one heart problem during the next year, compared with 7% of those who were not
given the antibiotic, according to the study by James Chalmers of the University
of Dundee, in Scotland, and colleagues.
'One heart problem'
In COPD patients, there was a significant association between the use of
clarithromycin and death from heart-related problems.
This association was not seen in pneumonia patients, according to a journal
The longer patients with COPD or pneumonia used clarithromycin, the greater
their risk of more heart problems. This was not the case with other antibiotics,
which suggests an effect specific to clarithromycin, according to the study
Overall, their findings suggest that there would be one additional heart
problem for every eight COPD patients and every 11 pneumonia patients who
receive clarithromycin, compared to patients who are not given the
The results also suggest that the increased risk of heart problems may last
after patients stop taking clarithromycin, possibly due to the effect that the
antibiotic has on the inflammation process in patients with chronic lung
conditions, the researchers said.
They said their findings need to be confirmed before any changes in the
treatment of COPD and pneumonia patients are made. Although the study showed a
link between the use of clarithromycin and possible heart problems, it did not
establish a cause-and-effect relationship.
The American Academy of Family Physicians has more about antibiotics.