Much time is spent discussing the development of antimicrobial resistance and changes to the microbiome but perhaps should we should also focus on the potential for patient mortality. Based on best current estimates, trimethoprim, macrolides and quinolones may be less safe than chloramphenicol in certain patient populations.
A future posting will provide a practical approach to the prolonged QT issue that may arise with macrolides and quinolones.
- Chloramphenicol – excerpt from Kucers, Use of Antibiotics
- Pichichero ME & Zagursky R Penicillin and Cephalosporin allergy. Annals of Allergy, Asthma & Immunology 2014;112:404-412
- Trimethoprim – see this previous posting
- Cheng YJ et al The role of macrolides in increasing cardiovascular risk. Journal of the American College of Cardiology 2015;66(20):2173-84
- Barza et al . Weighing the Adverse Cardiac Effects of Fluoroquinolones: A Risk Perspective. The Journal of Clinical Pharmacology 2015, 55(11) 1198–1206
Image : aplastic anaemia from Tulane University public image.