Short-term azithromycin use is associated with QTc interval prolongation in children with cystic fibrosis

IF 1.3 4区医学 Q3 PEDIATRICS Archives De Pediatrie Pub Date : 2024-07-01 DOI:10.1016/j.arcped.2024.02.004

Asım Enhoş , Hazar Doğuş Kus , Can Yilmaz Yozgat , Erkan Cakır , Hakan Yazan , Ahmet Berk Erol , Ufuk Erenberk , Yilmaz Yozgat

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Abstract

Background

Azithromycin is used for children with cystic fibrosis (CF) for its immunomodulatory and anti-inflammatory action. This study investigated the short-term alterations in QTc interval associated with azithromycin prophylaxis in pediatric patients with CF.

Methods

This study included 121 patients with mild CF, of whom 76 received azithromycin (patient group) and 45 did not receive azithromycin (control group). The patient and control groups were categorized according to age as under 12 years of age and over 12 years of age. The first presentation measured all the patient and control groups at basic QTc time intervals. The QTc intervals of all patients were then remeasured systemically at 1, 3, and 6 months. Age categories and QTc intervals that were calculated at each month in the patient and control groups were compared statistically.

Results

A statistically significant difference was detected in the patient group between the initial QTc interval time and the electrocardiogram (ECG) findings in the first and third months after prophylaxis treatment (p < 0.001; p = 0.01). However, no statistically significant difference was detected in the sixth month (p > 0.05) in all groups. Almost all of the children's QTc intervals were within normal range and within the safety zone (under 0.44 s). No statistically significant difference was detected in the control group between the initial ECG and the QTc intervals measured at 1, 3, and 6 months.

Conclusion

Short-term use of azithromycin prophylaxis in pediatric patients with mild CF slightly increased the QTc interval in the first and third months of follow-up. Nevertheless, all QTc interval changes fell within the safety zone. Notably, 1 month of follow-up treatment should be performed to check for any alteration in the QTc interval. If increased QTc interval duration is not detected in the first month, azithromycin prophylaxis can be safely prescribed.

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囊性纤维化患儿短期使用阿奇霉素与 QTc 间期延长有关。

背景阿奇霉素具有免疫调节和抗炎作用，可用于治疗儿童囊性纤维化（CF）患者。本研究调查了与阿奇霉素预防性治疗相关的儿童 CF 患者 QTc 间期的短期变化。方法本研究纳入了 121 例轻度 CF 患者，其中 76 例接受了阿奇霉素治疗（患者组），45 例未接受阿奇霉素治疗（对照组）。患者组和对照组按年龄分为 12 岁以下组和 12 岁以上组。首先测量所有患者组和对照组的基本 QTc 时间间期。然后在 1 个月、3 个月和 6 个月时对所有患者的 QTc 时间间期进行系统复测。结果发现，在预防性治疗后的第一和第三个月，患者组的初始 QTc 间期时间与心电图（ECG）结果之间存在显著差异（p < 0.001; p = 0.01）。然而，在第六个月时，所有组别均未发现明显的统计学差异（p > 0.05）。几乎所有儿童的 QTc 间期都在正常范围和安全区之内（0.44 秒以下）。在对照组中，最初的心电图与 1、3 和 6 个月时测量的 QTc 间期之间没有发现明显的统计学差异。尽管如此，所有QTc间期的变化都在安全范围内。值得注意的是，应在随访治疗 1 个月后检查 QTc 间期是否有任何变化。如果在第一个月未发现 QTc 间期延长，则可以放心服用阿奇霉素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives De Pediatrie 医学-小儿科

CiteScore

2.80

自引率

5.60%

发文量

106

审稿时长

24.1 weeks

期刊介绍： Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics. Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. Archives de Pédiatrie is the official publication of the French Society of Pediatrics.