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Biomed Pharmacother. 2017 Aug;92:196-206. doi: 10.1016/j.biopha.2017.05.049. Epub 2017 May 22.

Cardiotoxic effect of levofloxacin and ciprofloxacin in rats with/without acute myocardial infarction: Impact on cardiac rhythm and cardiac expression of Kv4.3, Kv1.2 and Nav1.5 channels.

Author information

1
Directorate of Health and Population, Ismailia, Egypt.
2
Deparment of Pharmacology & Toxicology, Faculty of Pharmacy, Suez Canal University, 41522, Ismailia, Egypt; Deparment of Pharmacology & Toxicology, Faculty of Pharmacy, University of Tabuk, Saudi Arabia. Electronic address: Sawsan_zaytoon@pharm.suez.edu.eg.
3
Deparment of Physiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
4
Deparment of Medical Biochemistry, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
5
Deparment of Pharmacology & Toxicology, Faculty of Pharmacy, Suez Canal University, 41522, Ismailia, Egypt.

Abstract

Prolongation of QT interval is possible with fluoroquinolones, yet the underlying contributing factors have not been elucidated. Two widely used fluoroquinolone drugs were at the focus of this study in rats with/without acute myocardial dysfunction (AMI) induced by isoproterenol. The effects of levofloxacin and ciprofloxacin on the cardiac mRNA expression of rat Kv4.3, Kv1.2 and Nav1.5 mRNAs were determined. Administration of the two antibiotics produced dose-dependent changes in ECG parameters that were more prominent in rats with AMI than healthy rats; this was accompanied by elevations in serum lactate dehydrogenase and creatine kinase-MB. Histopathological examination indicated some loss of striations, edema and fibrotic changes in rats with AMI; however the two antibiotics did not further exacerbate the cardiac histopathology. mRNA expression of the ion channels was altered in rats with AMI and healthy rats. In conclusion, long-term administration of levofloxacin and ciprofloxacin produced deleterious effects on the ECG pattern of rats with/without AMI. The effect was generally baseline-dependent and therefore, rats with AMI showed greater ECG disturbances and increases in cardiac enzymes. Taken together, these data make it advisable to monitor patients with a history of acute AMI requiring treatment with these antibiotics until data from human studies are available.

KEYWORDS:

Acute myocardial infarction; Cardiac ion channels; Ciprofloxacin; ECG; Levofloxacin; Rat

PMID:
28544933
DOI:
10.1016/j.biopha.2017.05.049
[Indexed for MEDLINE]

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