Antibiotics affecting heart- prolonging QT interval. Help!

Hi there.

I have been getting weekly ECKs to monitor the affect of my meds on my heart. When I started Azithromycin, my QT interval went up but I was still within the "normal limits". I added Bactrim to the mix one week ago. I had another ECG five days after starting the Bactrim and now my QT interval is very high. The cardiologist is considering having me stop the Bactrim.

But--- I have felt the best I have in a long time this past week. My fevers have been mostly normal all week. This is the first period of time since early September that I haven't had fevers over 100.

I'd love to hear from anyone else who has been struggling trying to manage the benefits of the antibiotics with the possible cardiac toxicity. The medications that are the worst offenders of QT prolongation are macrolides (Biaxin, Azithromycin), Bactrim, flagyl, Plaquenil, etc.

It seems like my situation has gotten much worse since I added a second medication that prolongs the QT interval. How am I ever going to get better and survive the meds?? This sucks so bad!

The only meds that appear to not mess with the heart definitively are tetracyclines and Penicillins, and Ceftin. Rifampin.

Evanston - if you've been feeling better since adding the Bactrim - what about stopping the azithromycin instead?


I remember looking into this awhile back...and some of the lists don't even have Bactrim on them...but I see the macrolides always on the lists.
I'm wondering if it is a higher risk with the macrolides?

...also if it was within limits with just one antibiotic...then just pair it with one that isn't affecting it.

One macrolide or bactrim can be paired with Rifampin, mino, doxy, Ceftin....etc.

There are still a lot of choices...if you are limited to only one abx that causes long qt

Agree with Girlie everyone around here knows I'm a big Bactrim fan it's what turned the corner for me. Try stopping the Zithro and only do Bactrim and since its 2 abx's combined its equivalent to abx combo therapy which is recommended for these bugs.

You can also go to a pulsing schedule (not take every day) to reduce QT interval impact.

Thanks everyone for chiming in! I'm worried that if I stop Azithromycin, the Babesia will develop resistance to Mepron. That is something I have read several different times. Do you think the Bactrim will suffice to reduce the risk of Mepron resistance?

I am also on Ceftin. I am seeing my doctor next week and I am sure she will add another med.

The other thought I had was to stop Mepron and start high dose Malarone, stay on Bactrim, and add possibly pulse Tindimax.... although Timdimax can mess with the QT interval too. Ugh!

I am in Evanston. Where are you? If you have a good local Dr, id love to find out Who! There appears to be no one in the area familiar with these infections.

How can i send you a private email? I'd love to get the name of a local dr from you.