Saturday, March 23, 2013

Should I Worry About Taking Azithromycin?


Azithromycin is one of the most widely used antibiotics in the United States.  In 2011 more than 40 million Americans received a prescription for azithromycin (Zithromax; Z-pak; Zmax).  Recently, the Food and Drug Administration distributed a drug safety announcement regarding the risk of azithromycin in causing fatal heart arrhythmias (irregular heart beat).  Should we now stop using azithromycin?
Here's how this drug safety warning came about.  Last year researchers reviewed the electronic records of Medicaid patients in Tennessee.  They found that persons receiving a short course of azithromycin were more likely to suffer death from cardiovascular disease, especially sudden death thought due to heart arrhythmia, than persons not receiving antibiotics or receiving an alternative antibiotic, amoxicillin.  If you were a person with no special risk for cardiovascular disease, then the increased risk of dying while taking azithromycin was approximately 1 in 111,000.  If you had serious underlying cardiovascular disease or a tendency to develop heart irregularity, the excess risk of dying while taking azithromycin was 1 in 4,000.  To put this in perspective, your risk of dying from a bolt of lightning is estimated at 1 in 84,000, and your risk of dying in an automobile accident is estimated at 1 in 100.
There are two classes of antibiotics that are known to predispose to irregular heart rhythms.  These are the family of antibiotics called macrolides (including azithromycin, clarithromycin [Biaxin], and erythromycin) and fluoroquinolones (including ciprofloxacin [Cipro], levofloxacin [Levaquin], and moxifloxacin [Avelox]).  The study cited above found that the risk of cardiovascular death when taking levofloxacin was the same as when taking azithromycin.  It also found that the risk of death from cardiovascular disease did not persist after the course of antibiotic.

Our take on this evidence? 

1.   The evidence suggesting that azithromycin can stimulate fatal heart arrhythmias is compelling and believable. 

2.      Will we continue to prescribe azithromycin for our otherwise healthy patients and family members for bacterial respiratory tract infections?  Yes.  Antibiotics remain among the relatively few drugs in our medical toolbox that can cure disease.
 
3.      People who should avoid azithromycin (and other macrolide antibiotics) and levofloxacin (and other fluoroquinolone antibiotics) are those with a known tendency to a particular type of irregular heart rhythm of the ventricle (ventricular arrhythmia) caused by slow electrical repolarization of the heart muscle, manifesting as prolongation of the QT interval on electrocardiogram.  Your doctor will know if you have “prolonged QT syndrome” or are taking other medications that might cause a prolonged QT interval, especially heart medicines such as dofetilide, amiodarone, or sotalol.  A very low blood level of potassium or an abnormally slow heart rate might also put you at risk for this type of heart arrhythmia.

4.      Is this evidence one more reason that otherwise healthy people with viral head and chest colds should take symptomatic treatment (such as acetaminophen [Tylenol], chicken soup, and tea with honey) rather than unnecessary and unhelpful antibiotics?  Definitely yes.

9 comments:

  1. If you can take care of yourself, asthma isn’t cause for alarm. Here are some ways to prevent future episodes.

    ReplyDelete
  2. If your diet is very strict, if your life style is stress free, and if you perform yoga regularly, you can live normal life - even if you have asthma.Eat healthy, think healthy, do healthy, and be healthy.

    ReplyDelete
  3. Asthma is not alarming if you work on it with your daily exercises. I have a friend who uses nebulizers for many years but finally recovered and now doing fine with her life. you must pay attention to keep your self from smokers, dust and stress. that's all.

    ReplyDelete
  4. Azithromycin generally should not be taken at regular basis as it not only affects the heart but also may lead to kidney failure if taken in much amount.So it's better to take it under doctor's prescription.

    Emergency care houston

    ReplyDelete
  5. Very informative, Thanks for sharing!

    ReplyDelete
  6. Great post, I agree with your evidence. It's better to just not take azithromycin. Thanks for sharing!

    ReplyDelete
  7. Azithromycin is a macrolide antibiotic used to treat different types of bacterial infections, which include skin infections, sinus infections, respiratory infections, throat infections, ear infections, and pneumonia. It is also used to treat sexually transmitted diseases, including gonorrhea and chlamydia. This medicine fights bacteria in the body.

    ReplyDelete
  8. So fantastic post very motive information thanks for SNOVITRA 60 MG TABLETS

    ReplyDelete

  9. A world is enough for a wise. I'm SEN.BUKA MORRIS from DENMARK.I was a Herpes patient for 7years ,i suffered a great lost in applying medical treatment to get cure from the virus. It was too scaring having does sleepless nights with Herpes. I went through many hospitals seeking for the solution to my cure all my efforts where rendered useless. I was so frustrated, and lost my lovely wife along the line due to the bad effects of her virus. I became so ashamed of myself. I decided to check on the internet if there could be any possible remedy to this dangerous virus . Then,I came across lots of comments about Dr.CHUKWU MADU HERBAL HOME, who's patience have recommended him of his Good work,testifying how his medicine saved their lives, and there have been living happily negative of their virus. I thought and believe I could be cure as well. Then,I decided to give it a try. To my greatest surprise after contacting him.,I was very happy in our first chat and I believe in everything he said. He really proved to me after going through lots of pics and videos with his patients. I then ordered for his medicine , he prepared and sent it through the DHL service.It was like a joke,but now a dream come through that I'm Herpes free, I have recently been confirmed HSV negative. All thanks to God for showing me the way to Dr CHUKWU MADU HERBAL HOME the great and powerful herbalist. Reach this herbalist on his email [dr.chukwumaduherbalhome@gmail.com] or +2347030936239.

    ReplyDelete