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Int J Infect Dis. 2019 Jan;78:50-56. doi: 10.1016/j.ijid.2018.10.017. Epub 2018 Oct 29.

The risk of cardiac events in patients who received concomitant levofloxacin and amiodarone.

Author information

1
Rutgers University School of Pharmacy, Piscataway, NJ, USA; RWJ Barnabas Health-Robert Wood Johnson University Hospital Somerset, Somerville, NJ, USA.
2
Rutgers University School of Pharmacy, Piscataway, NJ, USA; Chung-Ang University College of Pharmacy, Seoul, South Korea.
3
Columbia University School of Public Health, New York, NY, USA.
4
Rutgers University School of Pharmacy, Piscataway, NJ, USA.
5
RWJ Barnabas Health-Robert Wood Johnson University Hospital Somerset, Somerville, NJ, USA.
6
Chung-Ang University College of Pharmacy, Seoul, South Korea.
7
Chung-Ang University College of Pharmacy, Seoul, South Korea. Electronic address: dongsuh75@gmail.com.

Abstract

OBJECTIVES:

Levofloxacin and amiodarone are both known to prolong the QT interval. This study was conducted to estimate the risk of cardiac events in patients receiving concomitant levofloxacin and amiodarone.

METHODS:

The study included patients who were admitted to a large academic community medical center from 1/2012 to 12/2015 and received both levofloxacin and amiodarone at some point during their hospitalization. Patients received concomitant or non-concomitant levofloxacin and amiodarone during hospitalization. The primary outcome was the occurrence of cardiac events during therapy. The secondary outcome was the proportion of patients with an electrocardiogram performed before and after initiation of therapy. Odds ratios for cardiac events were calculated using a multivariable logistic regression model with and without adjusting for the study variables. The concomitant group was further evaluated for predictors of the primary outcome using multivariable logistic regression.

RESULTS:

This study included 240 patients, 164 (68.3%) of whom received concomitant levofloxacin and amiodarone. Concomitant medication therapy was associated with a greater than six-fold increased risk of cardiac events after adjusting for the study variables (Odds Ratio=6.20; 95% Confidence Interval=1.34-28.62).

CONCLUSIONS:

Patients receiving concomitant amiodarone and levofloxacin experienced a five-fold increase in cardiac events compared to patients given either medication alone.

KEYWORDS:

Amiodarone; Cardiac death; Cardiac risk; Levofloxacin; QT interval

PMID:
30385404
DOI:
10.1016/j.ijid.2018.10.017
[Indexed for MEDLINE]
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