盐酸莫西沙星注射液与注射用盐酸胺碘酮联用致QT间期延长

1例75岁男性因心脏瓣膜病合并心力衰竭及肺部感染给予盐酸莫西沙星注射液(莫西沙星)400mg静脉滴注、1次/d。第2天心电图示心率校正后QT间期(QTc)从治疗前的455ms延长至490ms。第3天凌晨因心房颤动给予注射用盐酸胺碘酮(胺碘酮)150mg缓慢静脉注射,中午给予胺碘酮300mg以30mg/h持续泵入。第4天下午再次给予胺碘酮300 mg,以30 mg/h速度持续泵入。泵入约20 min患者QTc延长至607ms。第5天未再使用胺碘酮,但患者QTc继续延长,最高达到674ms。第6天停用莫西沙星后其QTc逐渐恢复至正常范围内。考虑患者QT间期延长与莫西沙星和胺碘酮有关。

QT interval prolongation caused by concomitant use of moxifloxacin hydrochloride injection and amiodarone hydrochloride for injection

A 75-year-old male received an IV infusion of moxifloxacin hydrochloride injection(moxifloxacin)400mg/d once daily for valvular heart disease complicated with heart failure and pulmonary infection.On the second day,the electrocardiogram showed that the corrected QT interval(QTc)was prolonged from 455ms before treatment to 490ms.On the third day,amiodarone hydrochloride for injection(amiodarone)150mg was given by slow intravenous injection in the early morning due to atrial fibrillation and 300mg of amiodarone was continuously pumped at the speed of 30mg/h at noon.In the afternoon of the 4th day,amiodarone 300mg was given again via a pump at a speed of 30mg/h.About 20minutes later,the QTc was prolonged to 607ms.On the 5th day,amiodarone was not given again,but the QTc continued to be prolonged up to 674ms.On the 6th day,the QTc gradually returned to be within the normal range after discontinuation of moxifloxacin.The prolongation of QT interval in the patient was considered to be associated with moxifloxacin and amiodarone.