In a meta-analysis of 33 studies conducted, encompassing over 21 million patients, Chinese researchers, led by Su-Hua Wu, MD identified the positive association of macrolide antibiotic use, and the incidence of cardiovascular death and ventricular arrhythmias[i].
It was revealed that the use of these macrolides was associated with a 242% higher incidence (2.42 fold) of sudden coronary death or ventricular arrhythmias, but did not contribute to the occurrence of heart attacks, or death by other means.
Though the results demonstrated the higher affinity for these conditions, its lack of association to all-cause death was not proven, citing the need for further well designed studies.
Sami Viskin, MD, from Israel who authored an editorial related to this report, emphasized the importance of noting that this association translates to a roughly 1 in 30000 chance of dying from sudden coronary failure, and that hepatitis is a much more frequent, and deadly occurrence following the use of these drugs
Another researcher, iun-Ling Wang, MD from Taiwan, conducted a similar study in Taiwan[ii], explained that while the drugs may be needed, physicians needed to exercise greater caution in avoiding use of the macrolides in patients with known history of heart disease or arrhythmias, and that an alternate antibiotic class needed to be considered.
Though there has been no concrete evidence to suggest that macrolide usage contributes to all-cause death, it necessitates the need for a well-designed study to observe the results in patients who have to use the drugs. At this time, there is reasonable assurance to physicians who need to prescribe the medications to do so.
The Macrolides are a chemical class of drugs that consist primarily of the antibiotics Azithromycin, Clarithromycin, Erythromycin and Telithromycin, which are the most frequently use in clinical practice. The group also consist of two anti-fungal agents, nystatin and Amphotericin B, by virtue of their chemical structure.