Cardiologist Dr. Denis Sokolov points out that some macrolide antibiotics, such as azithromycin and clarithromycin, may affect the electrical activity of the heart.
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He says: “Imagine what might happen to a patient who already has a heart rhythm disorder, and then starts taking what’s left of their azithromycin or clarithromycin. Some antibiotics can affect the electrical activity of the heart, so it’s very important to make sure they are compatible with other medications, and not to take antibiotics without consulting a doctor.”
According to him, these drugs may inhibit potassium channels in heart cells, affecting the repolarization process and prolonging the QT interval on an electrocardiogram (ECG). The QT interval represents the time between the start of the Q wave and the end of the T wave, reflecting the time between electrical depolarization and repolarization in the heart's ventricles. Prolonging this interval may increase the risk of developing cardiac arrhythmias.
He says: "The risk of heart problems increases if a person is taking other medications concurrently with the antibiotic that may also affect the heart rhythm, such as some antiarrhythmics and antidepressants. In this case, some of them can enhance the effect of others."
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