Widely used antibiotic drug linked to greater heart attack risk

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In a recent study published in PLOS Medicine, researchers found why a commonly used antibiotic can lead to an increased risk of heart attacks.

The study is from the University of Dundee. One author is Dr. Ify Mordi.

Clarithromycin accounts for around 15% of all primary care antibiotic prescriptions in the UK and is recommended for the treatment of patients with chest infections.

In recent years it has been suggested that patients taking clarithromycin rather than alternative antibiotics were more likely to suffer a serious heart disease event, but research into this association had proved inconclusive.

In the study, the team explored both medical prescribing records and genetic data to determine whether clarithromycin use was indeed linked to an increased risk of heart problems.

They showed that, compared to patients prescribed amoxicillin, those taking clarithromycin were 31% more likely to be admitted to hospital with a heart problem within 14 days of starting the prescription and 13% more likely to be admitted to hospital with a heart problem up to a year after the conclusion of the prescription.

In addition, they found that patients also taking certain types of medications, such as statins, at the same time were even more likely to have a heart problem if given clarithromycin rather than amoxicillin.

Medications such as statins and clarithromycin work in the body using a pathway controlled by a protein called P-glycoprotein.

Using genetic data, the researchers found that patients with a genetic predisposition to lower P-glycoprotein activity were also at 40% higher risk of heart problems up to a year after prescription when taking clarithromycin rather than amoxicillin.

Taken together, these results suggest that patients should be prescribed alternative antibiotics if they are taking P-glycoprotein inhibitors such as statins, or if they have a particular genotype.

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