Analysis of the Treatment Plan for Q-T Interval Prolongation Caused by Moxifloxacin in One Case

Abstract

This case report presents the clinical treatment process of a 65-year-old female patient who experienced Q-T interval prolongation following the administration of moxifloxacin for a pulmonary infection. Upon hospital admission, the patient was initially treated with a combination of moxifloxacin and ceftazidime as part of an empirical anti-infective regimen. However, shortly after treatment commenced, the patient developed a skin rash accompanied by a significant prolongation of the Q-T interval as observed on the electrocardiogram (ECG), raising concerns about potential cardiac risks. In response, the clinical pharmacist conducted a timely medication review and recommended discontinuing both moxifloxacin and ceftazidime due to their possible adverse effects. Based on the pharmacist’s recommendation, the medical team revised the anti-infective regimen and substituted biapenem, a carbapenem antibiotic with a lower risk of cardiac side effects. Supportive symptomatic treatments were also provided to address the patient's condition holistically. As a result of these adjustments, the patient's rash gradually subsided, her Q-T interval normalised, and her overall symptoms significantly improved. She was eventually discharged in stable condition. This case highlights the potential cardiac risks associated with fluoroquinolone antibiotics like moxifloxacin, particularly in elderly patients who may be more susceptible to adverse drug reactions. Moreover, it underscores the essential role of clinical pharmacists in ensuring medication safety and optimising individualised treatment plans through active participation in multidisciplinary care teams.