Azithromycin routine in hospital despite risk for QTc prolongation

(HealthDay)—Azithromycin is routinely prescribed to hospitalized patients despite risk factors for corrected QT (QTc) prolongation and administration of interacting medications, according to a study published online Aug. 19 in the Journal of Hospital Medicine.

Rachael A. Lee, M.D., from the University of Alabama at Birmingham, and colleagues retrospectively analyzed data from 100 adult inpatients randomly selected from 1,610 patient encounters (October 2012 to April 2013), all of whom were treated with at least one dose of azithromycin. Telemetry charges and baseline electrocardiogram (ECG) prior to azithromycin administration were evaluated.

The researchers found that 79 percent of azithromycin use was empiric. Of the 65 patients who received a baseline ECG prior to prescribing azithromycin, 60 percent had borderline or abnormal QTc prolongation. There were more abnormal ECGs at baseline (P = 0.03) among the 76 percent of patients who were prescribed two or more QTc-prolonging medications in addition to azithromycin, despite having telemetry ordered less than half of the time.

"Selection of azithromycin by providers appears to be independent from these risk factors, and education and vigilance to drug-drug interactions may be useful in limiting cardiac events with prescribing azithromycin," the authors write.

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