Commonly Prescribed Antibiotic Linked To Higher Risk Of Death From Heart Disease

Antibiotics are usually prescribed to make us feel better, but one antibiotic could actually be damaging to our health.

New research suggests a commonly used antibiotic has been linked to a higher risk of deaths from heart problems.

Experts found that patients treated with clarithromycin, the fifth most commonly prescribed antibiotic in England last year, had a significantly higher risk of cardiac death compared to patients who were given another type of antibiotic.

Danish experts examined more than 160,000 people aged 40 to 74 across Denmark who received a seven-day course of clarithromycin and compared them to the 4.3 million who were prescribed penicillin V - the third most commonly proscribed antibiotic in England during 2013.

During the follow up period 285 people died from a cardiac problem while on the drugs - 18 people on clarithromycin, 235 people on penicillin V and 32 on another antibiotic roxithromycin.

The researchers found that ongoing use of clarithromycin, which is widely used for treating common bacterial infections, has a 76% higher risk of cardiac death compared to those who used penicillin V.

But they found that past use of the drug was not associated with an increased risk of death. Use of roxithromycin was also not associated with an increased risk.

The authors wrote, in their study published on thebmj.com: "Acute cardiac toxicity is an increasingly recognised potential adverse effect of antimicrobial drug treatment.

"In this study, we investigated the risk of cardiac death associated with the use of clarithromycin and roxithromycin, compared with penicillin V.

"Use of clarithromycin was associated with a significant 76% higher risk of cardiac death. We observed no significant increase in risk with roxithromycin.

"In terms of absolute risk, use of clarithromycin would account for an estimated 37 excess cardiac deaths per one million courses.

"In subgroup analyses, the increase in risk with clarithromycin seemed to be driven by a strong association among women."

SEE ALSO:
New £10 Heart Attack Blood Test Could Save Thousands Of Lives
Drug-Resistant 'Superbugs' Are On The Rise, Making Diseases Untreatable

But the authors stressed that more research needed to be conducted before the findings guided doctors on prescribing decisions.

Figures from the Health and Social Care Information Centre show that in England last year the most commonly prescribed antibiotic in was amoxicillin - with more than 13 million doses dished out - followed by flucloxacillin sodium, penicillin V, doxycycline hyclate and clarithromycin.

There were 2.2 million prescriptions written out for clarithromycin in 2013 - a rise from the 1.8 million given out in 2011.

Commenting on the study, Mike Knapton, associate medical director at the British Heart Foundation, said: "All medications can come with side effects, which is why your doctor will always weigh up the risks before prescribing drugs to patients.

"Health professionals already know to exercise caution when prescribing clarithromycin in patients who have, or may be pre-disposed to Long QT syndrome - a condition that can cause sudden cardiac death. This study shows that they should continue to follow that advice.

"More research is now needed to understand the effect of this antibiotic on the wider population. The bottom line is no one should be taking antibiotics unless they absolutely have to and doctors should give careful consideration before prescribing them.

"If you are taking clarithromycin at the moment, you should not stop without discussing this further with your GP."

Dr Andrew Seaton, consultant in infectious diseases and general medicine at NHS Greater Glasgow and Clyde Health Board, added: "Clarithromycin is used to treat bacterial upper and lower respiratory tract infections.

"As we have all heard recently, antibiotics can be overused and may be unnecessarily prescribed - in conditions where antibiotics are required, alternatives to clarithromycin should be considered when other risk factors for QTc prolongation (including clarithromycin metabolism inhibiting drugs, and certain heart conditions) are evident."

But Dr Tim Chico, reader in cardiovascular medicine at the University of Sheffield, said: "It would be a mistake to conclude that this study proves clarithromycin increases the risk of cardiac death.

"A slightly higher number of patients died while or soon after taking clarithromycin compared with penicillin but this may have been due to other differences between these patients, who the study authors acknowledge were different in several important ways.

"There are many good reasons to avoid unnecessary use of antibiotics such as trying to reduce development of bacteria that are resistant to treatment but I do not think that this study calls for a change in whether patients are prescribed clarithromycin."

7 Proven Ways To Prevent Heart Disease

2,000 extra daily steps = 10% lower risk(01 of07)

In this global study, adults over 50 who were at high risk of cardiovascular disease and diabetes who walked an additional 2,000 steps a day—about 20 minutes of brisk walking—reduced their risk of having a cardiovascular “event,” such as a heart attack or stroke, by 10 percent over the next six years. “Other than not smoking, nothing comes close to physical activity for prevention,” says Dr. Church. “Hundreds, if not thousands, of papers support it.” Achieving the goal of being physically active for 150 minutes a week, including strength training a couple of days a week, can reduce your cardiovascular risk by about 25 percent, he says. “There’s a dose response, which means the more you exercise, the more you benefit.” The biggest benefit, though, comes from going from sedentary to mildly active, such as walking 10 minutes a day. Says Dr. Church, “The biggest bang is just getting off the couch.” (credit:Shutterstock)

An 7 extra grams of fiber daily = 9% lower risk(02 of07)

In a meta-analysis of 22 studies, British researchers found that people who ate seven more grams of dietary fiber had a nine percent lower risk of heart disease. How much is that? A medium apple has 5 grams of dietary fiber, as does a half cup of cooked broccoli. A half cup of cooked lentils: 8 grams. Fruits, vegetables, beans, nuts, and whole grains are all good sources of fiber. “Fiber has beneficial effects on blood glucose and cholesterol, and it may keep your gastrointestinal tract healthier, reducing inflammation,” says Dr. Church. “Eating more fiber is also a marker of a healthier diet.” (credit:Shutterstock)

Daily glass of wine = 25% lower risk(03 of07)

“It’s pretty powerful,” says Dr. Church. “Drinking in moderation cuts your risk of heart disease by about 25 percent.” That’s defined as no more than one daily drink for a woman, two for a man. Not everyone can drink moderately, of course, but if you can, research shows it’s heart healthy.“It relaxes your blood vessels, so you can’t form a clot while alcohol’s on board,” says Dr. Church. “Any alcohol has benefits, but wine has a little more,” says Dr. Church. The healthiest pattern: “A drink or two every couple of days.” (credit:Shutterstock)

Multivitamins = zero heart benefit(04 of07)

The Agency for Healthcare Research Quality, a federal research agency, recently concluded that simply taking a multivitamin/multimineral pill won’t reduce your risk of heart disease. “It’s no surprise,” says Dr. Church. After all, preventing heart disease isn’t what multis are built to do—they’re to shore up nutrient deficiencies. “While the evidence for heart disease prevention isn’t there,” says Dr. Church, “taking multis won’t hurt you.” As for research that low vitamin D is associated with a 27 percent increased risk of developing heart disease, Dr. Church thinks it’s simply a marker for an inactive lifestyle, meaning since most people get their vitamin D from the sun, “people with high vitamin D levels are outside more—and probably more active,” he says. If you do have low D levels, Dr. Church supports taking supplements. But whether it will affect heart health isn’t fully clear. What he does think makes a difference: Omega 3 fatty acids, found primarily in fatty fish such as salmon. The American Heart Association recommends that healthy adults eat at least two fish meals a week. But if you don’t, won’t, or can’t, you may want to consider a 1-gram Omega supplement that includes both EPA and DHA, two forms of Omega 3s found in fish. While the heart disease preventive benefits of taking Omega 3 supplements hasn’t been established, says Dr. Church, “there is a lot of strong epidemiological evidence for Omega 3s. I’m a big proponent — I believe there’s value there.” (credit:Shutterstock)

Flu shot = 36% lower risk(05 of07)

This one has a catch—it’s about people who already have heart disease. A recent analysis found that in people with existing heart disease, getting the flu shot reduces the risk of cardiovascular events like a heart attack by 36 percent. “Getting the flu puts great stress on your body and increases the risk of having another heart attack,” says Dr. Church. A flu shot is a good idea for everyone—it’s not too late since flu peaks around the end of February, beginning of March!—and if you’re at high cardiovascular risk, or already have heart disease, that little jab could be a lifesaver. (credit:Shutterstock)

Mediterranean Diet = 30% lower risk(06 of07)

A major Spanish study found that men and women aged 55 to 80 who ate a Mediterranean diet were 30 percent less likely to have a heart attack or stroke, or die from heart disease, over the next five years. The most protective elements: olive oil as the primary fat, moderate alcohol (mostly from wine), lots of fruits, vegetables, nuts, legumes, and fish, and low consumption of meat. Just this week, a new American study of firefighters from the Midwest who followed a Mediterranean-style diet had lower cardiovascular risk factors: less belly fat, lower “bad” LDL cholesterol, and higher “good” HDL cholesterol. The great thing about Mediterranean studies is that they capture not just one healthy element but a pattern—a lifestyle. “We should look at risk factor clusters, and the Mediterranean lifestyle captures that,” says Dr. Church. Add the physical activity that’s part of a traditional Mediterranean lifestyle, and it’s really the big picture. (credit:Shutterstock)

A healthy lifestyle = 25% less chance of dying from heart disease(07 of07)

Talk about big picture. The Centers for Disease Control and Prevention recently estimated that if everyone didn’t smoke, ate a healthy diet, exercised regularly, achieved a healthy weight, and got regular checkups so they could control risk factors such as high blood pressure and elevated cholesterol levels, then death from heart disease would fall by 25 percent. That’s 200,000 lives saved – each year. (credit:Shutterstock)

antibiotics Health News Heart Disease uk lifestyle news medicine

Related