Risk assessment for antimicrobial agent-induced QTc interval prolongation and torsades de pointes

Over the past several years a multitude of new pharmaceutical agents have b een released to the market. Several of them were withdrawn altogether or th eir use severely restricted to certain indications due to unexpected advers e events, including fatalities. Progress in developing new compounds clearl y has surpassed our technology, in some cases, to measure and predict certa in toxicities. Prolongation of the QT interval, which may lead to potential ly life-threatening ventricular arrhythmias such as torsades de pointes, is one example. Regulatory agencies such as the Food and Drug Administration are increasing standards by which drugs are evaluated for cardiac toxicity related to QT interval prolongation. It is imperative that clinicians be kn owledgeable of the risk factors for QT prolongation and avoid the use of cu lpable agents in patients at risk for QT prolongation.