%0 Journal Article %1 Patel:2013:Ann-Intern-Med:23778904 %A Patel, A M %A Shariff, S %A Bailey, D G %A Juurlink, D N %A Gandhi, S %A Mamdani, M %A Gomes, T %A Fleet, J %A Hwang, Y J %A Garg, A X %D 2013 %J Ann Intern Med %K macrolides side_effects statins toxicity %N 12 %P 869-876 %R 10.7326/0003-4819-158-12-201306180-00004 %T Statin toxicity from macrolide antibiotic coprescription: a population-based cohort study %U http://www.ncbi.nlm.nih.gov/pubmed/23778904 %V 158 %X Chinese translationClarithromycin and erythromycin, but not azithromycin, inhibit cytochrome P450 isoenzyme 3A4 (CYP3A4), and inhibition increases blood concentrations of statins that are metabolized by CYP3A4.To measure the frequency of statin toxicity after coprescription of a statin with clarithromycin or erythromycin.Population-based cohort study.Ontario, Canada, from 2003 to 2010.Continuous statin users older than 65 years who were prescribed clarithromycin (n�= 72�591) or erythromycin (n�= 3267) compared with those prescribed azithromycin (n�= 68�478).The primary outcome was hospitalization with rhabdomyolysis within 30 days of the antibiotic prescription.Atorvastatin was the most commonly prescribed statin (73%) followed by simvastatin and lovastatin. Compared with azithromycin, coprescription of a statin with clarithromycin or erythromycin was associated with a higher risk for hospitalization with rhabdomyolysis (absolute risk increase, 0.02% 95% CI, 0.01% to 0.03%; relative risk RR, 2.17 CI, 1.04 to 4.53) or with acute kidney injury (absolute risk increase, 1.26% CI, 0.58% to 1.95%; RR, 1.78 CI, 1.49 to 2.14) and for all-cause mortality (absolute risk increase, 0.25% CI, 0.17% to 0.33%; RR, 1.56 CI, 1.36 to 1.80).Only older adults were included in the study. The absolute risk increase for rhabdomyolysis may be underestimated because the codes used to identify it were insensitive.In older adults, coprescription of clarithromycin or erythromycin with a statin that is metabolized by CYP3A4 increases the risk for statin toxicity.Academic Medical Organization of Southwestern Ontario.

@article{Patel:2013:Ann-Intern-Med:23778904, abstract = {Chinese translationClarithromycin and erythromycin, but not azithromycin, inhibit cytochrome P450 isoenzyme 3A4 (CYP3A4), and inhibition increases blood concentrations of statins that are metabolized by CYP3A4.To measure the frequency of statin toxicity after coprescription of a statin with clarithromycin or erythromycin.Population-based cohort study.Ontario, Canada, from 2003 to 2010.Continuous statin users older than 65 years who were prescribed clarithromycin (n�= 72�591) or erythromycin (n�= 3267) compared with those prescribed azithromycin (n�= 68�478).The primary outcome was hospitalization with rhabdomyolysis within 30 days of the antibiotic prescription.Atorvastatin was the most commonly prescribed statin (73%) followed by simvastatin and lovastatin. Compared with azithromycin, coprescription of a statin with clarithromycin or erythromycin was associated with a higher risk for hospitalization with rhabdomyolysis (absolute risk increase, 0.02% [95% CI, 0.01% to 0.03%]; relative risk [RR], 2.17 [CI, 1.04 to 4.53]) or with acute kidney injury (absolute risk increase, 1.26% [CI, 0.58% to 1.95%]; RR, 1.78 [CI, 1.49 to 2.14]) and for all-cause mortality (absolute risk increase, 0.25% [CI, 0.17% to 0.33%]; RR, 1.56 [CI, 1.36 to 1.80]).Only older adults were included in the study. The absolute risk increase for rhabdomyolysis may be underestimated because the codes used to identify it were insensitive.In older adults, coprescription of clarithromycin or erythromycin with a statin that is metabolized by CYP3A4 increases the risk for statin toxicity.Academic Medical Organization of Southwestern Ontario.}, added-at = {2013-06-25T12:24:08.000+0200}, author = {Patel, A M and Shariff, S and Bailey, D G and Juurlink, D N and Gandhi, S and Mamdani, M and Gomes, T and Fleet, J and Hwang, Y J and Garg, A X}, biburl = {https://www.bibsonomy.org/bibtex/23a4b48206c3c482f2ba04ea9121f7f36/iskanbasal}, description = {Statin toxicity from macrolide antibiotic cop... [Ann Intern Med. 2013] - PubMed - NCBI}, doi = {10.7326/0003-4819-158-12-201306180-00004}, interhash = {fa4372dd7ed974ac36441ba7f3ecc906}, intrahash = {3a4b48206c3c482f2ba04ea9121f7f36}, journal = {Ann Intern Med}, keywords = {macrolides side_effects statins toxicity}, month = jun, number = 12, pages = {869-876}, pmid = {23778904}, timestamp = {2013-06-25T12:24:08.000+0200}, title = {Statin toxicity from macrolide antibiotic coprescription: a population-based cohort study}, url = {http://www.ncbi.nlm.nih.gov/pubmed/23778904}, volume = 158, year = 2013 }