Is cardiovascular risk a concern when prescribing azithromycin?

The FDA has updated azithromycin package labeling to include the risk of prolonged cardiac repolarization and QT prolongation, which increase the possibility of cardiac dysrhythmias and torsades de pointes, especially in older adults. The update was initiated by a study that found an increased risk of death in patients taking azithromycin compared with those taking amoxicillin. However, cardiovascular results of other azithromycin studies have demonstrated discordant results, and more research is needed. In the meantime, providers should recognize that azithromycin has a role in the management of bacterial infections and should prescribe the antibiotic when warranted.