Bradycardia and hypothermia complicating azithromycin treatment
© 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...
| Main Authors: | , , , , |
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| Format: | Journal Article |
| Published: |
2017
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| Online Access: | http://hdl.handle.net/20.500.11937/63097 |
| _version_ | 1848760993519239168 |
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| author | Benn, K. Salman, S. Page-Sharp, Madhu Davis, T. Buttery, J. |
| author_facet | Benn, K. Salman, S. Page-Sharp, Madhu Davis, T. Buttery, J. |
| author_sort | Benn, K. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 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 35.2°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. |
| first_indexed | 2025-11-14T10:24:36Z |
| format | Journal Article |
| id | curtin-20.500.11937-63097 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:24:36Z |
| publishDate | 2017 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-630972023-02-22T06:24:15Z Bradycardia and hypothermia complicating azithromycin treatment Benn, K. Salman, S. Page-Sharp, Madhu Davis, T. Buttery, J. © 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 35.2°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. 2017 Journal Article http://hdl.handle.net/20.500.11937/63097 10.12659/AJCR.905400 unknown |
| spellingShingle | Benn, K. Salman, S. Page-Sharp, Madhu Davis, T. Buttery, J. Bradycardia and hypothermia complicating azithromycin treatment |
| title | Bradycardia and hypothermia complicating azithromycin treatment |
| title_full | Bradycardia and hypothermia complicating azithromycin treatment |
| title_fullStr | Bradycardia and hypothermia complicating azithromycin treatment |
| title_full_unstemmed | Bradycardia and hypothermia complicating azithromycin treatment |
| title_short | Bradycardia and hypothermia complicating azithromycin treatment |
| title_sort | bradycardia and hypothermia complicating azithromycin treatment |
| url | http://hdl.handle.net/20.500.11937/63097 |