The antibiotics azithromycin and levofloxacin may put patients at a higher risk of death or cardiac arrhythmia than amoxicillin, according to a study in Annals of Family Medicine.
Researchers analyzed data of almost one million U.S. veterans who were prescribed one of these three antibiotics at the Department of Veterans Affairs between September 1999 and April 2012.
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Azithromycin was typically dispensed for five days, and levofloxacin and amoxicillin were typically dispensed for at least 10 days.
Patients receiving azithromycin were 1.48 times more likely to die and 1.77 times more likely to experience cardiac arrhythmia during the first five days of antibiotic treatment than patients receiving amoxicillin.
Patients receiving levofloxacin were 2.49 times more likely to die and 2.43 times more likely to experience cardiac arrhythmia during the first five days of antibiotic treatment than patients receiving amoxicillin. For days six through 10, the risks remained heightened for levofloxacin patients, who were 1.95 times more likely to die and 1.75 times more likely to experience cardiac arrhythmia.
However, researchers noted that the absolute risk of adverse events linked to these antibiotics is very low. The overall number of deaths per million antibioitics dispensed after 10 days of treatment was 324 for amoxicillin, 422 for azithromycin and 714 for levofloxacin, according to a MedPage Today report on the study.
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