ERYTHROMYCIN-INDUCED TORSADES-DE-POINTES AND VENTRICULAR-FIBRILLATIONIN A PATIENT WITH LEGIONELLA-PNEUMONIA

Several case reports of erythromycin-induced torsades de pointes (TDP) arrhythmia have been reported in the literature. However, this potent ially lethal side-effect of a frequently prescribed drug is not genera lly known. We report a patient who developed TDP followed by ventricul ar fibrillation during rapid infusion of erythromycin lactobionate. Al though the patient used diuretics, probably predisposing her to arrhyt hmias due to hypokalaemia, several ECG abnormalities predisposing to T DP, all related to erythromycin infusion, occurred during observation in the ICU, establishing the precipitating role of erythromycin. The d iagnosis was made only after QT prolongation, TDP and ventricular fibr illation were observed during rapid intravenous infusion of erythromyc in lactobionate, one of the reasons no doubt being the assumed lack of serious side-effects of this frequently prescribed drug.