Moxifloxacin and torsade de pointes.
OBJECTIVE
To report a case of torsade de pointes in a patient receiving moxifloxacin.


METHODS
An 87-year-old woman was admitted to the hospital for pneumonia, and antibiotic therapy with intravenous moxifloxacin 400 mg/day was initiated. The patient was noted to have significant QTc interval prolongation 2 hours after administration of moxifloxacin and developed torsade de pointes 8-10 hours after moxifloxacin administration. She was converted back to normal sinus rhythm after a precordial thump. Moxifloxacin was discontinued, and the woman's QTc interval subsequently returned to baseline.


CONCLUSIONS
Torsade de pointes is a life-threatening arrhythmia that has previously been associated with the use of fluoroquinolones. Minimal information is available regarding the risk of torsade de pointes with moxifloxacin. According to the Naranjo probability scale, the episode in this case was probably related to administration of intravenous moxifloxacin.


CONCLUSIONS
In patients with underlying risk factors for a prolonged QT interval, the use of moxifloxacin can lengthen the interval further and ultimately trigger episodes of torsade de pointes. Moxifloxacin administration in these patients therefore should be administered and monitored judiciously.
Dale
Krista M
KM
Division of Cardiology, School of Pharmacy, University of Connecticut, Hartford, CT, USA.
Lertsburapa
Kirkeith
K
Kluger
Jeffrey
J
White
C Michael
CM
D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001372:Aza Compounds / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004562:Electrocardiography; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D007275:Injections, Intravenous; D000077266:Moxifloxacin; D011804:Quinolines / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000175:diagnosis; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin