{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T04:19:24Z","timestamp":1765772364958,"version":"3.48.0"},"reference-count":30,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,1,11]]},"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction and objectives<\/jats:title>\n                    <jats:p>Macrolides have been associated with proarrhythmic properties, but the evidence is conflicting. We evaluated the risk of out-of-hospital cardiac arrest (OHCA) associated with specific macrolides in a retrospective study. Associations between specific macrolides and OHCA were examined by conditional logistic regression analyses in case-crossover and case\u2013time\u2013control models, using penicillin-V treatment as the comparative reference. From nationwide registries, we identified all OHCAs in Denmark from 2001 to 2010 and use of antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics<\/jats:title>\n                    <jats:p>The present study was approved by the Danish Data Protection Agency (Danish Data Protection Agency (ref.no. 2007-58-0015, local ref.no. GEH-2014-017, (I-Suite.nr. 02\u2009735)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>We identified 29\u2009111 patients with an OHCA. Of these, 514 were in macrolide treatment \u22647 days before OHCA and 1237 in penicillin-V treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the case-crossover analyses, overall macrolide use was not associated with OHCA with penicillin V as negative comparative reference (OR=0.90; 95% CI 0.73 to 1.10). Compared with penicillin-V treatment, specific macrolides were not associated with increased risk of OHCA: roxithromycin (OR=0.97; 95% CI 0.74 to 1.26), erythromycin (OR=0.68; 95% CI 0.44 to 1.06), clarithromycin (OR=0.95; 95% CI 0.61 to 1.48) and azithromycin (OR=0.85; 95% CI 0.57 to 1.27).<\/jats:p>\n                    <jats:p>\n                      Similar results were obtained using case\u2013time\u2013control models: overall macrolide use (OR=0.81; 95% CI 0.62 to 1.06) and specific macrolides (roxithromycin\n                      <jats:bold>(<\/jats:bold>\n                      OR=0.70; 95% CI 0.49 to 1.00), erythromycin\n                      <jats:bold>(<\/jats:bold>\n                      OR=0.67; 95% CI 0.38 to 1.18), clarithromycin\n                      <jats:bold>(<\/jats:bold>\n                      OR=0.75; 95% CI 0.41 to 1.39) or azithromycin\n                      <jats:bold>(<\/jats:bold>\n                      OR=1.17; 95% CI 0.70 to 1.95)).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The risk of OHCA during treatment with macrolides was similar to that of penicillin V, suggesting no additional risk of OHCA associated with macrolides.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019997","type":"journal-article","created":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T08:30:20Z","timestamp":1519374620000},"page":"e019997","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Does macrolide use confer risk of out-of-hospital cardiac arrest compared with penicillin V? A Danish national case-crossover and case\u2013time\u2013control study"],"prefix":"10.1136","volume":"8","author":[{"given":"Frederik Boetius","family":"Hertz","sequence":"first","affiliation":[{"name":"Department of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aksel","family":"Jensen","sequence":"additional","affiliation":[{"name":"Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark"},{"name":"Research Center for Vitamins and Vaccines (CVIVA), Bandim Health Project, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny D","family":"Knudsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magnus","family":"Arpi","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunnar H","family":"Gislason","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital, Gentofte, Copenhagen, Denmark"},{"name":"The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"},{"name":"The Research Department, The Danish Heart Foundation, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars","family":"K\u00f8ber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Torp\u2013Pedersen","sequence":"additional","affiliation":[{"name":"Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Freddy","family":"Lippert","sequence":"additional","affiliation":[{"name":"Prehospital Emergency Medical Services, On behalf of the Capital, Central Denmark, Northern, South Denmark and Zealand Regions, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter E","family":"Weeke","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,2,23]]},"reference":[{"key":"2025121219563000000_8.2.e019997.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2003.00798.x"},{"key":"2025121219563000000_8.2.e019997.2","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1601"},{"key":"2025121219563000000_8.2.e019997.3","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.80a.13077"},{"key":"2025121219563000000_8.2.e019997.4","unstructured":"FDA.gov. 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