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Cohort study
The cardiovascular risk of azithromycin was increased in a large observational cohort study, contradicting findings from prior randomised trials
  1. Joseph Brent Muhlestein
  1. Department of Cardiology, Intermountain Medical Center, Murray, Utah, USA
  1. Correspondence to : Dr Joseph Brent Muhlestein
    Department of Cardiology, IMC, 5121 S Cottonwood Street, Murray, UT 84107, USA; Brent.Muhlestein{at}

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Azithromycin, a widely used broad-spectrum macrolide antibiotic, belongs to the same class of antibiotics as erythromycin and clarithromycin, both of which have been associated with an increased risk of potentially lethal arrhythmias. Azithromycin has generally been viewed as ‘safe’ from a cardiovascular standpoint, but recently several reports of azithromycin-associated QT interval prolongation have been published. In an effort to ascertain whether azithromycin carries any cardiovascular risk, Ray et al evaluated the effect of its use on risk of death in a large Tennessee Medicaid cohort.


The cohort study included patients (aged 30–74 years who took azithromycin from 1992 to 2006 (347 795 prescriptions)). Subjects were excluded if they had life-threatening non-cardiovascular illness, history of drug abuse, residency in a …

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  • Competing interests None.