MOXIFLOXACIN INDUCED QT INTERVAL PROLONGATION: A RISK TO TORSADE DE POINTES IN ELDERLY PATIENTS
Keywords:
Moxifloxacin, QT interval, Torsade de Pointes, Bazett's formula, ECGAbstract
Background: Quinolones are notorious for QT interval prolongation and sometimes carry risks for development of Torsade de Pointes. Objective of this study was to determine the effect of moxifloxacin on QT interval prolongation on electrocardiogram. Methods: It was a cross-sectional study, conducted in Medical Department of Mardan, Medical Complex, Mardan, from January to December 2021. Moxifloxacin was given for treatment of different ailments to 57 patients after approval of study protocols from Ethical Committee of Gajju Khan Medical College/Bacha Khan Medical Complex Swabi. Their baseline ECGs, second ECG on its Tmax and third set of ECGs were recorded, in triplicates, on 48 hours of treatment. QTc was calculated using Bazett’s formula either using lead II or alternatively AVR, AVF, V5, V6, or V4, leads. Moxifloxacin was administered in recommended doses. Results: Of the 57 patients, 24 patients (42%) showed QTC prolongation (prolonged QTc: For male >450 ms, and for female >470 ms); and 19 patients (33%) reached to the limits for a risk (Patients with QTc >500 ms or QTc change over baseline >60 ms) for development of Torsade de pointes. Remaining 14 patients (25%) faced no complications. Statistically significant changes were observed for both male and female patients (p<0.05). However, QT prolongation was sustained for 48 hours in female only. Conclusion: Moxifloxacin produced significant changes in QTc particularly in elderly patients. Mean changes in QTc on 48 hours were prolonged in females than males.
Pak J Physiol 2023;19(4):11–4
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