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Macrolide QT risk — GPhC CRA MCQ

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HardInfectionsMacrolide QT riskGPhC CRA

A 76-year-old taking citalopram and amiodarone, with documented QT prolongation, receives clarithromycin for a chest infection. What is the pharmacist’s priority?

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Correct answer: E — Query clarithromycin and request an antimicrobial with lower QT risk

Clarithromycin, citalopram and amiodarone can each prolong QT, and this patient already has a prolonged interval. Timing separation does not remove the pharmacodynamic risk. The antibiotic indication and alternatives should be reviewed before supply, with urgent assessment if arrhythmic symptoms are present.

Reference: BNF: clarithromycin: https://bnf.nice.org.uk/drugs/clarithromycin/