title: Rare Incidence of Ventricular Tachycardia and Torsades de Pointes in Hospitalized Patients With Prolonged QT Who Later Received Levofloxacin: A Retrospective Study.
abstract: OBJECTIVE
  To determine the incidence of ventricular tachycardia and ventricular fibrillation in patients with prolonged corrected QT interval (QTc) who received levofloxacin through retrospective chart review at a tertiary care teaching hospital in the United States.
  
  
  METHODS
  We selected 1004 consecutive hospitalized patients with prolonged QTc (>450 ms) between October 9, 2009 and June 12, 2012 at our institution. Levofloxacin was administered orally and/or intravenously and adjusted to renal function in the inpatient setting. The primary outcome measure was sustained ventricular tachycardia recorded electrocardiographically.
  
  
  RESULTS
  With a median time from the start of levofloxacin use to hospital discharge (or death) of 4 days (range, 1-94 days), only 2 patients (0.2%; 95% CI, 0.0%-0.7%) experienced the primary outcome of sustained ventricular tachycardia after the initiation of levofloxacin use.
  
  
  CONCLUSIONS
  In this study, the short-term risk for sustained ventricular tachycardia in patients with a prolonged QTc who subsequently received levofloxacin was very rare. These results suggest that levofloxacin may be a safe option in patients with prolonged QTc; however, studies with longer follow-up are needed.
authors: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL.
authors: Fernando F
authors: FF
authors: Stancampiano
authors: Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL.
authors: William C
authors: WC
authors: Palmer
authors: CRISP Investigative Research Program, Mayo Clinic, Jacksonville, FL.
authors: Trevor W
authors: TW
authors: Getz
authors: CRISP Investigative Research Program, Mayo Clinic, Jacksonville, FL.
authors: Neysa A
authors: NA
authors: Serra-Valentin
authors: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL.
authors: Steven P
authors: SP
authors: Sears
authors: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL.
authors: Kristina M
authors: KM
authors: Seeger
authors: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL.
authors: Ricardo J
authors: RJ
authors: Pagan
authors: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL.
authors: Ronald G
authors: RG
authors: Racho
authors: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL.
authors: Jordan C
authors: JC
authors: Ray
authors: Department of Cardiology, Mayo Clinic, Rochester, MN.
authors: David F
authors: DF
authors: Snipelisky
authors: Department of Internal Medicine, Mayo Clinic, Jacksonville, FL.
authors: John J
authors: JJ
authors: Mentel
authors: Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL.
authors: Nancy N
authors: NN
authors: Diehl
authors: Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL.
authors: Michael G
authors: MG
authors: Heckman
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D064704:Levofloxacin / Q000009:adverse effects*; D008133:Long QT Syndrome / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000139:chemically induced* / Q000453:epidemiology*; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000453:epidemiology*
chemical_list: D000900:Anti-Bacterial Agents; D064704:Levofloxacin