Bradycardia and hypothermia complicating azithromycin treatment
MetadataShow full item record
Â© Am J Case Rep, 2017. Objective: Unusual or unexpected effect of treatment Background: Azithromycin is a macrolide antibiotic widely used to treat respiratory, urogenital, and other infections. Gastrointestinal upset, headache, and dizziness are common adverse effects, and prolongation of the rate-corrected electrocardiographic QT interval and malignant arrhythmias have been reported. There are rare reports of bradycardia and hypothermia but not in the same patient. Case Report: A 4-year-old boy given intravenous azithromycin as part of treatment for febrile neutropenia complicating leukemia chemotherapy developed hypothermia (rectal temperature 35.2Â°C) and bradycardia (65 beats/minute) after the second dose, which resolved over several days post-treatment, consistent with persistence of high tissue azithromycin concentrations relative to those in plasma. A sigmoid E max pharmacokinetic/pharmacodynamic model suggested a maximal azithromycin-associated reduction in heart rate of 23 beats/minute. Monitoring for these potential adverse effects should facilitate appropriate supportive care in similar cases. Conclusions: Recommended azithromycin doses can cause at least moderate bradycardia and hypothermia in vulnerable pediatric patients, adverse effects that should prompt appropriate monitoring and which may take many days to resolve.
Showing items related by title, author, creator and subject.
Prolonged therapeutic hypothermia does not adversely impact neuroplasticity after global ischemia in ratsSilasi, G.; Klahr, A.; Hackett, Mark; Auriat, A.; Nichol, H.; Colbourne, F. (2012)Hypothermia improves clinical outcome after cardiac arrest in adults. Animal data show that a day or more of cooling optimally reduces edema and tissue injury after cerebral ischemia, especially after longer intervention ...
Deasy, C.; Bernard, S.; Cameron, P.; Jacobs, Ian; Smith, K.; Hein, C.; Grantham, H.; Finn, Judith (2011)Background: The International Liaison Committee on Resuscitation (ILCOR) now recommends therapeutic hypothermia (TH) (33°C for 12-24 hours) as soon as possible for patients who remain comatose after resuscitation from ...
Optimal antimalarial dose regimens for chloroquine in pregnancy based on population pharmacokinetic modellingSalman, S.; Baiwog, F.; Page-Sharp, Madhu; Kose, K.; Karunajeewa, H.; Mueller, I.; Rogerson, S.; Siba, P.; Ilett, K.; Davis, T. (2017)Despite extensive use and accumulated evidence of safety, there have been few pharmacokinetic studies from which appropriate chloroquine (CQ) dosing regimens could be developed specifically for pregnant women. Such optimised ...