From the Guidelines
Tachycardia after discontinuation of antibiotics is not a normal reaction and should be evaluated by a healthcare provider to determine the underlying cause, which could be a rebound effect, an underlying infection, or an adverse reaction to the antibiotic. This symptom might represent a rebound effect as your body adjusts to the absence of the medication, an underlying infection that wasn't fully treated, or an adverse reaction related to the antibiotic itself, as suggested by the guidelines for the management of adult patients with supraventricular tachycardia 1. Some antibiotics like fluoroquinolones (ciprofloxacin, levofloxacin) or macrolides (azithromycin, clarithromycin) can directly affect heart rhythm, and these effects might persist briefly after discontinuation.
Possible Causes of Tachycardia
- Rebound effect: The body's adjustment to the absence of the medication
- Underlying infection: The infection may not have been fully treated, leading to ongoing inflammation and increased heart rate
- Adverse reaction: The antibiotic itself may have caused an adverse effect on the heart rhythm
- Dehydration: Certain antibiotics can cause dehydration, which may contribute to tachycardia
- Recurring or worsening infection: The body's inflammatory response to the infection could trigger increased heart rate
Importance of Medical Evaluation
If you experience a sustained elevated heart rate (over 100 beats per minute at rest) after stopping antibiotics, especially if accompanied by fever, shortness of breath, chest pain, or feeling faint, seek medical attention promptly, as recommended by the guidelines for the management of patients with supraventricular arrhythmias 1. Your doctor may need to evaluate whether the original infection requires further treatment or if you're experiencing a medication-related effect. The clinical history and physical examination are crucial in determining the type of arrhythmia and the underlying cause of tachycardia, as emphasized in the guidelines for the management of patients with supraventricular arrhythmias 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Tachycardia after Discontinuation of Antibiotics
- Tachycardia, or an increased heart rate, can be a side effect of certain antibiotics, such as moxifloxacin 2.
- The increase in heart rate caused by antibiotics can be statistically significant, but may not always be clinically relevant 2.
- There is limited research on the specific topic of tachycardia after discontinuation of antibiotics, but it is known that some antibiotics can increase the risk of cardiac arrhythmias, including torsades de pointes (TdP) 3.
- The risk of arrhythmia associated with antibiotic use is generally low, but can be increased in certain individuals with underlying heart conditions or other risk factors 3.
- Tachycardia is not always a reliable indicator of serious bacterial infection (SBI) in children, and may not be a useful diagnostic test in this context 4.
Related Research
- A study on the use of beta blockers to prevent and control atrial fibrillation (AF) in patients with sepsis and non-cardiac infections found that beta blockers may be safe and effective in this context 5.
- Research on the topic of stopping antibiotics when patients feel better suggests that this approach may help reduce unnecessary exposure to antibiotics and decrease the risk of antimicrobial resistance and antibiotic side effects 6.
- However, there are still many challenges and evidence gaps that need to be addressed before this approach can be considered evidence-based and implemented in practice 6.