In a VA North Texas Health Care System and University of Texas Southwestern Medical Center, Dallas study of nearly 65,000 patients 65 years and older who were hospitalized with pneumonia, treatment that included azithromycin compared with other antibiotics was associated with a significantly lower risk of death and a slightly increased risk of heart attack.
The final analysis reported in the June 4 issue of JAMA included 31,863 patients who received azithromycin and 31,863 matched patients who did not, but some other guideline-concordant therapy. The researchers found that 90-day mortality was significantly lower in those who received azithromycin (17.4 percent, vs 22.3 percent). There was also an increased odds of heart attack (5.1 percent vs 4.4 percent), but not any cardiac event (43.0 percent vs 42.7 percent), cardiac arrhythmias (25.8 percent vs 26.0 percent), or heart failure (26.3 percent vs 26.2 percent).
Pneumonia and influenza together are the eighth leading cause of death and the leading causes of infectious death in the United States, and despite recent research suggesting that azithromycin may be associated with increased cardiovascular events, this study indicates that the benefits of azithromycin treatment for it far outweigh the possible risks.