Journal of Antimicrobial Chemotherapy (2000) 45, 557-559
© 2000 The British Society for Antimicrobial Chemotherapy
Leading article |
Quinolone-induced QT interval prolongation: a not-so-unexpected class effect
School of Biomedical Sciences, University of St Andrews, St Andrews, Fife, UK
The recent abrupt withdrawal of grepafloxacin by Glaxo Wellcome, in association with seven possibly associated, sudden cardiac deaths and several cases of torsade de pointes, details of which have not apparently reached the public domain, has again highlighted the phenomenon of quinolone-induced QT prolongation and the potential for associated ventricular tachy-arrhythmias originally described with sparfloxacin.1 In anticipation of the predatory activity which often characterizes realization of apparent, but often factually unfounded comparative advantage by competitor marketing departments within the pharmaceutical industry, it is pertinent to re-examine the facts.
Quinolone-related torsade de pointes and other malignant ventricular tachy-arrhythmias have been described very rarely and only with sparfloxacin,1,2 levofloxacin3,4 and, most recently, grepafloxacin. However, during preclinical animal toxicological assessment, all quinolones so far adequately investigated have proved to prolong the QT interval.3,5,6 For grepafloxacin, QT prolongation is observed in both rabbits and
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