title: Macrolide-induced digoxin toxicity: a population-based study.
abstract: In this 15-year, population-based, nested case-control study, we investigated the association between hospitalization for digoxin toxicity and recent exposure to individual macrolide antibiotics. Clarithromycin was associated with the highest risk of digoxin toxicity (adjusted odds ratio (OR) 14.8; 95% confidence interval (CI) 7.9-27.9), whereas erythromycin and azithromycin were associated with much lower risk (adjusted OR 3.7; 95% CI 1.7-7.9; and adjusted OR 3.7; 95% CI 1.1-12.5, respectively). We found no increased risk with a neutral comparator, cefuroxime (adjusted OR 0.8; 95% CI 0.2-3.4).
authors.affiliation: The Institute for Clinical Evaluative Sciences, Ontario, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Gomes
authors.forename: M M
authors.initials: MM
authors.lastname: Mamdani
authors.forename: D N
authors.initials: DN
authors.lastname: Juurlink
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D017963:Azithromycin / Q000494:pharmacology; D002316:Cardiotonic Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D017291:Clarithromycin / Q000494:pharmacology; D015897:Comorbidity; D004077:Digoxin / Q000009:adverse effects*; D004347:Drug Interactions; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D006801:Humans; D018942:Macrolides / Q000009:adverse effects*; D008297:Male; D019338:Polypharmacy
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000900:Anti-Bacterial Agents; D002316:Cardiotonic Agents; D018942:Macrolides; D004917:Erythromycin; D004077:Digoxin; D017963:Azithromycin; D017291:Clarithromycin