A new study has reported that the underlying risk for sudden cardiac death increases even more when a fluoroquinolone rather than an amoxicillin-based antibiotic is used to treat respiratory infections. 

Experts recommend that respiratory fluoroquinolones should be prescribed to patients receiving hemodialysis when an amoxicillin-based antibiotic would be suboptimal. 

Fluoroquinolones such as levofloxacin and amoxifloxacin are among the most common medications with QT interval-prolonging prescribed to patients on hemodialysis. Almost 20% of respiratory fluoroquinolone treatments in their study were concurrent with the use of other drugs with known torsade de pointes risk. 

The researchers have also emphasized that clinicians should consider electrocardiographic monitoring before and during therapy, especially in high-risk individuals.

Reference

Assimon MM, Pun PH, Chin-Hua Wang L, et al. Analysis of respiratory fluoroquinolones and the risk of sudden cardiac death among patients receiving haemodialysis. JAMA Cardiol. Published online October 20, 2021. doi:10.1001/jamacardio.2021.4234