Abdelazeem Basel, Hollander Rachel M, Ayad Sarah, Gergis Kirolos, Gismalla Mohamed E
Internal Medicine, McLaren Health Care/Michigan State University (MSU), Flint, USA.
Internal Medicine, Michigan State University, College of Human Medicine, Flint, USA.
Cureus. 2021 Aug 8;13(8):e16995. doi: 10.7759/cureus.16995. eCollection 2021 Aug.
Azithromycin is a broad-spectrum antibiotic of the macrolide class and has multiple effects on the cardiovascular system, including prolonged corrected QT (QTc) interval. However, there is limited literature on the association between azithromycin and bradyarrhythmias. Monitoring the patient via telemetry can detect bradycardia. The diagnosis of azithromycin-induced bradycardia is usually made by the exclusion of other causes of bradycardia. We report a case of a 44-year-old female with past medical history of obstructive sleep apnea who presented to our hospital due to polysubstance drug overdose with possible aspiration pneumonia. The patient received azithromycin and subsequently developed symptomatic bradycardia two days post-onset of antibiotic treatment. This case raises awareness amongst physicians about the possibility of azithromycin-induced bradycardia and explains the different mechanisms that can cause it.
阿奇霉素是一种大环内酯类广谱抗生素，对心血管系统有多种影响，包括延长校正QT（QTc）间期。然而，关于阿奇霉素与缓慢性心律失常之间关联的文献有限。通过遥测对患者进行监测可检测到心动过缓。阿奇霉素诱发的心动过缓通常通过排除其他心动过缓原因来诊断。我们报告一例44岁女性病例，该患者有阻塞性睡眠呼吸暂停病史，因多种药物过量且可能合并吸入性肺炎而入住我院。患者接受阿奇霉素治疗，抗生素治疗开始两天后出现症状性心动过缓。该病例提高了医生对阿奇霉素诱发心动过缓可能性的认识，并解释了可能导致心动过缓的不同机制。
