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Drug Safety
Published in: Drug Safety 2/2009

01-02-2009 | Original Research Article

Effect of Macrolide and Fluoroquinolone Antibacterials on the Risk of Ventricular Arrhythmia and Cardiac Arrest

An Observational Study in Italy Using Case-Control, Case-Crossover and Case-Time-Control Designs

Authors: Dr Antonella Zambon, Hernan Polo, Paolo Contiero, Giovanni Corrao

Published in: Drug Safety | Issue 2/2009

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Abstract

Objective: To compare the effect of macrolide and fluoroquinolone antibacterials on the onset of ventricular arrhythmia and cardiac arrest using three different observational designs.
Methods: A population-based case-control study was performed by linking automated databases from the Varese Province of Italy. Cases were all subjects who experienced ventricular arrhythmia or cardiac arrest from July 1998 to December 2003. For each case, up to ten controls were randomly selected after matching for sex, age, practitioner and date of arrhythmia onset. The use of macrolides and fluoroquinolones during two time windows denoted as recent and referent intervals was ascertained. Odds ratios were estimated using case-control, case-crossover and case-time-control approaches.
Results: 1275 cases and 9189 controls met the inclusion criteria. Adjusted odds ratios (and corresponding 95% CIs) associated with recent exposure to macrolides were 2.13 (1.34, 3.39), 1.70 (0.88, 3.26) and 1.62 (0.78, 3.34) by using case-control, case-crossover and case-time-control designs, respectively. The corresponding estimates for fluoroquinolones were 3.58 (2.51, 5.12), 1.98 (1.19, 3.29) and 1.59 (0.88, 2.87), respectively.
Conclusions: Three observational study designs each using entirely different sets of controls consistently showed that recent use of macrolide and fluoro-quinolone antibacterials may be associated with increased risk of ventricular arrhythmia and cardiac arrest.
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Metadata
Title
Effect of Macrolide and Fluoroquinolone Antibacterials on the Risk of Ventricular Arrhythmia and Cardiac Arrest
An Observational Study in Italy Using Case-Control, Case-Crossover and Case-Time-Control Designs
Authors
Dr Antonella Zambon
Hernan Polo
Paolo Contiero
Giovanni Corrao
Publication date
01-02-2009
Publisher
Springer International Publishing
Published in
Drug Safety / Issue 2/2009
Print ISSN: 0114-5916
Electronic ISSN: 1179-1942
DOI
https://doi.org/10.2165/00002018-200932020-00008

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