• Sean N Avedissian, Nathaniel J Rhodes, NgTien M HTMH0000-0003-2251-8268Department of Clinical Pharmacy, University of Southern California, Los Angeles, California., Adupa P Rao, and Paul M Beringer.
• Department of Pharmacy Practice, Chicago College of Pharmacy, Midwestern University, Chicago, Illinois.
• Pharmacotherapy. 2019 Jun 1; 39 (6): 718-723.

IntroductionOral azithromycin (AZM) has been shown to reduce airway inflammation and disrupt biofilm formation. However, chronic AZM therapy may result in QT interval (QTc) prolongation.ObjectivesThe goals of this study were twofold: (i) to characterize the risk of QTc prolongation in adult patients with cystic fibrosis (CF) receiving AZM and other potential QTc-prolonging agents, and (ii) to describe and capture the number of potential QTc-prolonging agents patients with CF are prescribed.MethodsA retrospective study was conducted over a 3-year period in an adult CF center. QTc values were recorded from electrocardiograms. Univariate and multivariate analyses were conducted. Standard QTc prolongation definitions (males ≥ 450 msec, females ≥ 470 msec) were used.ResultsA total of 89 adult CF patient's records were reviewed. Sixty-eight patients received chronic AZM therapy. Two male patients had prolonged QTc, but only 1 received chronic AZM therapy. The median QTc interval between patients receiving and not receiving AZM was not significantly different (405 [interquartile range, IQR: 388-425] vs 394 [IQR: 384-413] msec, respectively, p=0.14). Also, the QTc interval for patients taking chronic AZM 500 mg Monday/Wednesday/Friday or 250 mg daily was not significantly different (401 [IQR: 383-419] vs 409 [IQR: 394-427] msec, respectively, p=0.48). When stratified by the number of QTc-prolonging medications (AZM vs no AZM), there was no significant difference in median QTc values between patients receiving zero to ≥ 5 QTc-prolonging medications.ConclusionAn association between chronic AZM therapy and longer QTc intervals or significant QTc prolongation was not shown.© 2019 Pharmacotherapy Publications, Inc.

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