From the Research
Fluoroquinolone antibiotics should be avoided in patients with hypertrophic cardiomyopathy (HCM) due to the potential risk of prolonging the QT interval and triggering dangerous arrhythmias, as supported by the most recent study in 2023 1. The use of fluoroquinolones in HCM patients is a concern due to their mechanism of blocking certain potassium channels in cardiac cells, which affects cardiac repolarization, and this effect is particularly problematic in HCM patients whose hearts already have structural abnormalities and potentially altered electrical conduction. Some key points to consider when managing HCM patients include:
- The importance of close cardiologic supervision with ECG monitoring before and during treatment if fluoroquinolone therapy is absolutely necessary, as highlighted in various studies 2, 3, 4, 5.
- Alternative antibiotic classes such as penicillins, cephalosporins, or macrolides are typically safer options for HCM patients, depending on the infection being treated.
- Patients with HCM taking fluoroquinolones should immediately report symptoms like palpitations, dizziness, or syncope, as these could indicate cardiac rhythm disturbances requiring immediate medical attention. The most recent study in 2023 1 found that moxifloxacin was associated with an increased risk of cardiovascular events, including aortic valve regurgitation, and that the receipt of moxifloxacin and elevated baseline QT interval were associated with an increased risk of cardiovascular events. Therefore, it is crucial to prioritize the safety of HCM patients and avoid the use of fluoroquinolones whenever possible, in order to minimize the risk of cardiovascular adverse events and improve patient outcomes in terms of morbidity, mortality, and quality of life.