Erythromycin-induced cardiac toxicity

Our observations suggest that the onset of erythromycin-induced cardiac toxicity (torsades de pointes and myocardial depression) correlates with high serum levels of the drug. To circumvent these potentially dangerous effects, large fluctuations in serum concentration should be avoided. Administration with the lowest possible infusion rate is advisable, and it may be prudent to monitor cardiac rhythm and QT intervals before and during administration of higher doses.