Abstract:
:While there is evidence for cardiac arrhythmias associated with macrolide and fluoroquinolone antibiotics, there is still debate among health care providers as to whether this risk of arrhythmia is overstated. A joint panel of the US Food and Drug Administration suggested that macrolide and fluoroquinolone labels need much stronger warnings regarding the possible serious adverse cardiac effects associated with these antibiotics, especially since they are so widely prescribed. And while health care providers may differ on the pertinence of the cardiac risks associated with antibiotic use, they can undoubtedly minimize the cardiac effects that are associated with these antibiotics by paying attention to the cardiac risk factors and drug history associated with the patient. Relevant studies for our review were identified from a PubMed search using keywords and combined word searches involving macrolides, fluoroquinolones, and cardiac arrhythmias. We attempted to include as many recent (>2015) articles as possible. We included case reports, randomized, controlled trials, observational studies, case-control studies, systematic reviews, and retrospective studies. Underlying cardiac issues can predispose patients to harmful cardiac side effects that can be exacerbated in the presence of antibiotics. The health care provider should rule out any risk factor associated with antibiotic-induced cardiac arrhythmia in the event that a patient does need a macrolide or fluoroquinolone antibiotic. Rigorous patient evaluation and a detailed patient history, including short and long term medication use, is the likely key to reducing any risk of cardiac arrhythmias associated with macrolides and fluoroquinolones. Clinicians should be cautious when prescribing macrolide and fluoroquinolone medications to patients with risk factors that may lead to antibiotic-induced cardiac arrhythmias, including a slow heart rate and those that are taking medications to treat arrhythmias.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Cornett E,Novitch MB,Kaye AD,Pann CA,Bangalore HS,Allred G,Bral M,Jhita PK,Kaye AMdoi
10.1080/00325481.2017.1362938subject
Has Abstractpub_date
2017-09-01 00:00:00pages
715-724issue
7eissn
0032-5481issn
1941-9260journal_volume
129pub_type
杂志文章,评审abstract::Severe gastroesophageal reflux disease is usually a chronic problem with periods of relapse, but effective medical and surgical therapies are available. Two recently introduced agents, omeprazole (Prilosec) and cisapride (Propulsid), represent advances in medical therapy; the safety of long-term, continuous omeprazole...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-05-01 00:00:00
abstract::Present evidence suggests that the most important nutritional factor bearing on the risk of development of diabetes mellitus is an excessive caloric intake. Other evidence suggests that both dietary prevention of diabetes and mitigation of hyperglycemia by dietary means can prevent morbidity and mortality from the mic...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11712096
更新日期:1976-09-01 00:00:00
abstract::In scarcely more than 30 years, the People's Republic of China has progressed from limited health care available only to a privileged few to a countrywide system providing basic services to one fifth of the world's population. The author gives his impressions of the current situation, based on a recent visit. :There ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715824
更新日期:1981-08-01 00:00:00
abstract::The use of topical tretinoin (Retin-A) for comedonal lesions, benzoyl peroxide for inflamed papules and pustules, and topical or oral antibiotics for more severe or widespread disease gives excellent results for the majority of patients with acne. At present, oral isotretinoin (13-cis-retinoic acid) (Accutane) should ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698996
更新日期:1985-05-01 00:00:00
abstract::Asthma and chronic obstructive pulmonary disease (COPD) are disorders that affect millions of people in the United States and other countries in the world. Asthma is a chronic inflammatory disease of the airways that has cellular and molecular pathways. Affected patients have recurrent episodes of wheezing, dyspnea, c...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.12.2005.suppl44.232
更新日期:2005-12-01 00:00:00
abstract::Because some cases of hearing loss demand urgent attention, an approach to patients with hearing loss should be adopted in the primary care setting that allows for systematic institution of an individualized and appropriate treatment plan. Workup is enhanced by categorizing the hearing loss as acute or chronic and con...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::Albuminuria has a strong, continuous, direct, linear relationship with adverse cardiovascular (CV) outcomes and chronic kidney disease progression. Even at levels below the accepted upper limit of what is considered "normal" daily albumin excretion (< 30 mg/24 h), a relationship between albumin excretion level and adv...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2009.07.2031
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVES:We investigated whether there was a higher prevalence of cognitive impairment (CI) and/or physical frailty (PF) in persons with diabetes compared to their non-diabetic counterparts, and the individual and combined impact of CI and PF on functional and mortality outcomes among diabetic older persons. METHOD:...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2018.1491779
更新日期:2018-08-01 00:00:00
abstract::Preview Severe metabolic complications of diabetes mellitus are a common cause of morbidity and death in both type I and type II disease. The distinctions between diabetic ketoacidosis and hyperosmolar nonketotic state are clearly defined, and accurate recognition is important for proper treatment. This article focuse...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1996.11946141
更新日期:1996-06-01 00:00:00
abstract::Primary care physicians have a crucial role in recognition of potentially emergent conditions in patients with known or suspected cancer. This task presents a significant challenge because the initial manifestations of these conditions are usually nonspecific. In most cases, therapy is far more effective when diagnosi...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1990.11704773
更新日期:1990-12-01 00:00:00
abstract::Severe illness of any type predictably leads to abnormal results on thyroid function tests. The first apparent changes are a decrease in total triiodothyronine (T3) and an increase in reverse T3. As disease progresses, a marked decline in thyroxine and an increase in T3 resin uptake are observed. Thyrotropin levels re...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11700751
更新日期:1989-06-01 00:00:00
abstract::The concurrent use of opioids, benzodiazepines (BZDs), and/or alcohol poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contri...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.07.2684
更新日期:2013-07-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714271
更新日期:1976-02-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2002.10.1333
更新日期:2002-10-01 00:00:00
abstract::Overuse syndrome and peripheral nerve entrapment syndromes arise in work situations in which the body is stressed beyond its limits by cumulative, repetitive trauma. These syndromes arise in some nonwork situations as well. When such an injury occurs, prompt diagnosis, treatment, and retraining aid in returning the em...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11700031
更新日期:1987-11-01 00:00:00
abstract::In a case of rheumatic disease, the patient's history and a careful physical examination should yield most of the information needed to identify the specific disorder present. A convenient classification is based on four differentiating features: number of joints affected, acuteness or chronicity of disease, absence o...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11708414
更新日期:1976-12-01 00:00:00
abstract:OBJECTIVE:Laparoscopic adjustable gastric banding (LAGB) is an established bariatric surgical procedure that produces meaningful weight loss and improvements in patients with type 2 diabetes mellitus (T2DM) and a body mass index (BMI) ≥ 30 kg/m2. This study examined the effect of LAGB on T2DM status in severely obese p...
journal_title:Postgraduate medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.3810/pgm.2012.11.2590
更新日期:2012-11-01 00:00:00
abstract::When many physicians think of managed care, they think first of Kaiser Permanente, the nation's largest HMO. That perception is misguided, according to David M. Lawrence, MD, the chief executive officer and chairman of the boards of the Kaiser Foundation health plan and hospitals. During a phone interview recently, La...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945854
更新日期:1994-05-15 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715249
更新日期:1979-09-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1998.10.450
更新日期:1998-10-01 00:00:00
abstract::Fungal infections usually have characteristics that make them easily identifiable. In most cases, clinical diagnosis can be readily confirmed by examining the lesions under Wood's light or by placing infected material in potassium hydroxide solution and examining the preparation microscopically. Dermatophytes can be r...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714412
更新日期:1976-07-01 00:00:00
abstract::Preview There is considerable overlap in features and treatment of chronic obstructive pulmonary disease and asthma. Why, then, is it necessary to distinguish between the two? As the authors explain, the two diseases have different causes, risk factors, and clinical courses. Correct diagnosis, described in this articl...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945862
更新日期:1994-06-01 00:00:00
abstract::Gastroesophageal reflux disease is a very common condition that is usually manifested by heartburn or regurgitation. Reflux esophagitis, caused by mucosal exposure to the backflow of caustic gastric contents, is primarily a result of lower esophageal sphincter dysfunction. Diagnostic workup varies but commonly include...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11700938
更新日期:1991-05-15 00:00:00
abstract::Preview A patient limps into your office with ankle pain and a story about a popping sound he heard during a mad dash to the net on a tennis court. After evaluation, you diagnose complete rupture of the Achilles tendon. Do you apply a cast or refer him to an orthopedic surgeon? When are the higher risks and costs asso...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1995.11946048
更新日期:1995-09-01 00:00:00
abstract::Women predominate at all ages among patients diagnosed as having primary fibromyalgia. Of 100 patients reviewed, the average age at onset of fibromyalgia was 46. Of 65 patients in whom menopause occurred before diagnosis of fibromyalgia, the average age at menopause was 42, and most of these women had menopause relate...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699544
更新日期:1986-09-15 00:00:00
abstract::In a large percentage of patients with upper airway disease, asthma and sinusitis occur concomitantly. As many as 88% of patients with asthma exhibit the symptoms of rhinitis, and half of rhinitic patients have asthma. In this article, Dr Muller explores the interrelationship of sinusitis and asthma, including charact...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.10.1263
更新日期:2000-10-01 00:00:00
abstract::This article on microcytic anemia is the first of several on laboratory investigation of anemia. Microcytic anemia, characterized by a mean corpuscular volume of less than 80 cu mu, is usually due to iron deficiency or chronic disease but may signify thalassemia minor. Exact identification of the cause is important, s...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715037
更新日期:1979-01-01 00:00:00
abstract::Cluster headache is a syndrome of severe head and facial pain accompanied by autonomic abnormalities. Men are affected more frequently than women. Headaches occur daily during periods of susceptibility, which may be followed by periods of remission. The etiology of cluster headache is uncertain. Recent work suggests t...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
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更新日期:1992-02-15 00:00:00
abstract::The many types of pigmentation disorders may present in diverse forms and distributions and have various causes. They can be inherited (eg, vitiligo, familial periorbital hyperpigmentation), acquired (eg, postinflammatory pityriasis alba, idiopathic guttate hypomelanosis, Becker's nevus, melasma), infectious (eg, tine...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1996-06-01 00:00:00
abstract::The fact that atopic dermatitis is such a common medical problem underlies the need for better understanding of the basic disease processes and the development of new therapeutic approaches. Infection is now recognized as an important exacerbating factor, and the role of inflammatory and immunologic mediators is recei...
journal_title:Postgraduate medicine
pub_type: 杂志文章
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更新日期:1984-07-01 00:00:00