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(The New York Times)   Azithromycin may increase the likelihood of sudden death in adults, especially those who have heart issues. Hey, my dentist prescribes that for me, because of my heart operation. Seriously she does. THUD   (nytimes.com) divider line 46
    More: Scary, Columbia University Medical Center, preventive medicines, IMS Health, sore throats, bacterial infections, overuse of antibiotics, Infectious Diseases Society of America, stents  
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3774 clicks; posted to Main » on 17 May 2012 at 11:51 AM (3 years ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2012-05-17 12:45:19 AM  
Let's weigh the options. Trust someone to complete a 10-day course or a 3-day course... Hmmm...

So, how many more people would die from drug-resistant strains compared to a few heart attacks?

Fine, if you're old and geezerly, take the whole course of your Amox.

Seems like a really slight risk. Compliance to the longer course seems to be the main problem. If they don;t follow the course and die from whatever else is ailing them, you're negating the life-savings from the heart problems.

Please feel free to correct me, but that's my observation.
 
2012-05-17 11:56:13 AM  
farm6.static.flickr.com
 
2012-05-17 11:56:31 AM  
anti-bio-tic?

Stops the ticker, 'eh?
 
2012-05-17 12:00:50 PM  
Azithromycin may increase the likelihood of sudden death in adults, especially those who have heart issues. Hey, my dentist prescribes that for me, because of my heart operation. Seriously she does. THUD

3.bp.blogspot.com
 
2012-05-17 12:02:07 PM  
Lovely.

I can't take Amoxycillin (several allergic reaction). I have a heart condition which requires me to take antibiotics before dental work. Guess what my dentist gives me? HINT: It ain't Amoxycillin.
 
2012-05-17 12:06:40 PM  

Wenchmaster: I can't take Amoxycillin (several allergic reaction). I have a heart condition which requires me to take antibiotics before dental work. Guess what my dentist gives me? HINT: It ain't Amoxycillin.


Toothpaste?
 
2012-05-17 12:08:11 PM  
Ah, America! Who in your great country can't prescribe drugs?
 
2012-05-17 12:15:03 PM  
I'm 46 and just took azithromycin last week for strep throat, so I'm gett
 
2012-05-17 12:15:48 PM  
The problem is that it's really a wunderdrug for those of us who are resistant or affected poorly by the *cillins. I am careful about which antibiotics I will take because I don't want to become resistant to everything. However, so far Zithro has been really wonderful, and it works well the few times my son's needed it too.
 
2012-05-17 12:20:20 PM  

Aidan: I am careful about which antibiotics I will take because I don't want to become resistant to everything


(cue the Morbo pic)
Antibiotics don't work that way!
 
2012-05-17 12:22:03 PM  

docmattic: Aidan: I am careful about which antibiotics I will take because I don't want to become resistant to everything

(cue the Morbo pic)
Antibiotics don't work that way!


*snerk*

I meant "resistant to most easy-to-take, readily available, low-cost antibiotics", naturally. :P
 
2012-05-17 12:25:27 PM  

Wenchmaster: Lovely.

I can't take Amoxycillin (several allergic reaction). I have a heart condition which requires me to take antibiotics before dental work. Guess what my dentist gives me? HINT: It ain't Amoxycillin.


Last I checked, the American Heart Association no longer recommends antibiotics before dental work except for people with really serious heart conditions(like replacement valves or major congenital defects) AND when you're getting serious dental work like gum surgery. It was apparently never really effective and the risk from taking antibiotics plus the contribution to antibiotic resistance outweighed benefits. I knew this from my own experience of having dentists who keep up with current medical literature but here are a couple of quickly dredged up links from the tubes:

Link

Link
 
2012-05-17 12:32:15 PM  
I never really got why you take antibiotics before dental work. Presumably they're going to introduce some bacteria laden crap into a small cut in your mouth. Problem is, plenty of people will do the exact same thing just brushing their teeth or flossing, especially if they don't do it as often as recommended.

I have heart issues, and have taken antibiotics before for dental work. 2 1/2 years ago my heart problems got a lot worst, I came down with congestive heart failure and had a pacemaker/ICD implanted. I needed a root canal done a month after I got out of the hospital, so I asked my cardiologist about this, she said not to bother with the antibiotics. My dentist's take was yea, why protect you when you're in here, then just tell you to go home and floss which will likely do the exact same thing.
 
2012-05-17 12:42:40 PM  

Arnprior Joe: I needed a root canal done a month after I got out of the hospital, so I asked my cardiologist about this, she said not to bother with the antibiotics. My dentist's take was yea, why protect you when you're in here, then just tell you to go home and floss which will likely do the exact same thing.


OK, so the root canal was a bad example since I'd already have taken an antibiotic to combat the already existing infection related to the abcess. But the same went for other dental work.
 
2012-05-17 12:42:58 PM  

Devolving_Spud: I'm 46 and just took azithromycin last week for strep throat, so I'm gett


This, except taking it right now. hurra
 
2012-05-17 12:43:46 PM  
Hey, my college professor was one of the people on the team that made this drug.
 
2012-05-17 12:52:21 PM  
CASB time:

Two months ago, I was having trouble fighting a cold and went to the clinic. The doctor there ended up giving me a prescription for Azithromycin, and we talked about how it will stay in the system for a few days, and how I thought that was a clever way of getting people to keep taking after they feel better.

Monday was the fifth day. I went in to work, started feeling terrible, and went home. I didn't get all the way home before I started throwing up. I got home, ended up passing out, I'm not sure what happened. I woke up, called the pharmacy, and asked if I should go to the hospital.

"Is your vision blurry?"

"I don't know, I'm not wearing my glasses."

"Is your hearing okay?"

"I've been unconcious. I don't know."

"Okay, take some gravol to help with the nausea and call back if you lose vision or hearing. Drink lots of juice or gatorade to keep hydrated. "

I threw up, lost track of what number barf this was, and went back to sleep. A few hours later, I crawled downstairs to get some juice and gravol. I woke up a few hours later.

I went back upstairs and slept. It was weird, my brain kept trying to boot, but my body kept responding "161/163 hardware error". I was asleep from 1300 on Monday to 0730 on Tuesday. I woke up on Tuesday feeling fine, but down 5% of my body weight. I'm still down five pounds and it looks like that's permanent. (Not that I had tons to lose.)

So I'm getting a "Oh, I actually could have died..." out of these replies.

/Had arrythmia
//Heart output is 20% above normal
///Actually see a cardiologist
////35.
 
2012-05-17 12:59:15 PM  
Amoxicillin is a better prophylactic antibiotic for dental procedures, subbs.

/followed by clindamycin
 
2012-05-17 01:08:43 PM  
Great. Every time I've ever had to take an antibiotic I've been prescribed Azithromycin.

/Must have taken it a dozen times by now.
//Oh well, maybe I can get in on the inevitable lawsuit.
 
2012-05-17 01:14:16 PM  
I'm on the z-pac right now so I am getting a kick etc.,

/Just had a full "check-up" on my heart and it's doing fine.
 
2012-05-17 01:22:33 PM  
Azithromycin makes me barf like a motion-sick cholera patient with food poisoning, so I'm really getting a kick out of this news. Really.
 
2012-05-17 01:23:11 PM  

Aidan: The problem is that it's really a wunderdrug for those of us who are resistant or affected poorly by the *cillins. I am careful about which antibiotics I will take because I don't want to become resistant to everything. However, so far Zithro has been really wonderful, and it works well the few times my son's needed it too.


This. And it works wonders if you get bronchitis often, like I do. I'll take the risk. I don't get the Z-pak very often as it is kinda pricey when you have no insurance, so the doc ususally gives me Amoxicillin, except if I am really in a bad way.


we just drop dead, also diabetes runs in the family. it's like shoot craps in Vegas
 
2012-05-17 02:03:36 PM  

Catlike Typist: Azithromycin makes me barf like a motion-sick cholera patient with food poisoning, so I'm really getting a kick out of this news. Really.


Funny, it makes me break out in bleeding rashes so I try and stay away from it.

Always a fun discussion when docs ask me if I have any drug alergies

"Yeah doc, I'm alergic to Azithromycin"

"Yeah, how do you react?"

"I break out in blood."
 
2012-05-17 02:11:59 PM  

Aidan: The problem is that it's really a wunderdrug for those of us who are resistant or affected poorly by the *cillins. I am careful about which antibiotics I will take because I don't want to become resistant to everything. However, so far Zithro has been really wonderful, and it works well the few times my son's needed it too.


Uh, it's not *you* personally who becomes resistant, it's whatever strain of bug you're trying to get rid of. You may be intolerant or allergic however.
 
2012-05-17 02:15:06 PM  

Froman: Last I checked, the American Heart Association no longer recommends antibiotics before dental work except for people with really serious heart conditions(like replacement valves or major congenital defects) AND when you're getting serious dental work like gum surgery. It was apparently never really effective and the risk from taking antibiotics plus the contribution to antibiotic resistance outweighed benefits. I knew this from my own experience of having dentists who keep up with current medical literature but here are a couple of quickly dredged up links from the tubes:

Link

Link


My dentist actually agrees with you. My cardiologist, on the other hand, insists I take the stuff.
 
2012-05-17 02:19:24 PM  

Wenchmaster: My dentist actually agrees with you. My cardiologist, on the other hand, insists I take the stuff.


And who would you rather take medical advice from?
 
2012-05-17 02:54:39 PM  

theMagni: CASB time:

Two months ago, I was having trouble fighting a cold and went to the clinic. The doctor there ended up giving me a prescription for Azithromycin, and we talked about how it will stay in the system for a few days, and how I thought that was a clever way of getting people to keep taking after they feel better.

Monday was the fifth day. I went in to work, started feeling terrible, and went home. I didn't get all the way home before I started throwing up. I got home, ended up passing out, I'm not sure what happened. I woke up, called the pharmacy, and asked if I should go to the hospital.

...etc.


Jesus that sucks! I took Azithromycin once for a severe sinus infection and also had a severe allergic reaction. I felt so terrible I almost had my mother call an ambulance. I had to crawl back to my bed from the bathroom. Every doctor I've been to has tried to prescribe it to me since then and I always tell them HELL NO. I had heart surgery after I was born and have a slight heart murmur so no idea if that was the contributing factor but it was farking AWFUL.
 
2012-05-17 03:58:45 PM  

basemetal: Wenchmaster: My dentist actually agrees with you. My cardiologist, on the other hand, insists I take the stuff.

And who would you rather take medical advice from?


The guy who doesn't profit from the medical advice one way or another?
 
2012-05-17 04:05:23 PM  
This is some SCARY shiat!

Now we won't know who's responsible for cosleeping deaths..
(Dad on Azithromycin)
i.imgur.com
 
2012-05-17 04:40:07 PM  

hollowmoon:
Jesus that sucks! I took Azithromycin once for a severe sinus infection and also had a severe allergic reaction. I felt so terrible I almost had my mother call an ambulance. I had to crawl back to my bed from the bathroom. Every doctor I've been to has tried to prescribe it to me since then and I always tell them HELL NO. I had heart surgery after I was born and have a slight heart murmur so no idea if that was the contributing factor but it was farking AWFUL.


Heh, I had to get my daughter to bring me the phone and the pill bottle. They drank all the juice on the bottom shelf, and I was afraid of fainting when standing up.

At least we know now not to take it, right?

ANd one more thing: as the pharmacist explained to me a few days afterwards, that's not an allergy. An allergic reaction is when you have to go to the hospital and get counter-active drugs and IVs because you can't breathe and you're going to die. When you pass out, blow your body's BIOS settings, and throw up 8% of your body weight, that's a sensitivity.

I knew it wasn't flu because I was... uh, only throwing up out of one end. Also I was fine the next day. (For certain values of "fine")
 
2012-05-17 06:09:06 PM  
oh, yay.

Because I have a compromised immune system, I get a zpack whenever I so much as sniffle for too many days. (Another round of bronchitis could kill me.)

Thank goodness my heart is the only part of me that seems to not be farked up.
 
2012-05-17 07:44:50 PM  
What are Farkers' opinions on levofloxicin/Levaquin?
 
2012-05-17 08:09:42 PM  
Harry Knutz: What are Farkers' opinions on levofloxicin/Levaquin?

I try to avoid it unless it's necesary based on the bug not being sensitive to anything else. I'll take it for Psuedomonas, which tends to be the cause of my ear infections, but I won't take it for anything else. Give me Amoxil or Zithromax any day over it.

One of the major side effects of fluoroquinolones like levaquin in active indiviudals is tendon sprain and rupture. Considering my day to day job includes regularly lifting 300lbs of dead weight with a baby inside of it, yeah....
 
2012-05-17 08:11:32 PM  

BronyMedic: Considering my day to day job includes regularly lifting 300lbs of dead weight with a baby inside of it


I'm listening.
 
2012-05-17 09:57:07 PM  

Quantum Apostrophe: Aidan: The problem is that it's really a wunderdrug for those of us who are resistant or affected poorly by the *cillins. I am careful about which antibiotics I will take because I don't want to become resistant to everything. However, so far Zithro has been really wonderful, and it works well the few times my son's needed it too.

Uh, it's not *you* personally who becomes resistant, it's whatever strain of bug you're trying to get rid of. You may be intolerant or allergic however.


Really! I didn't know that. I always thought it was the same bug. I get chronic ear infections, which is pretty much just mucus clogging up in my tubes and then becoming infected. I just assumed it was the same wee nasty and that Amoxicillin was getting progressively less and less useful because my body processed it too fast or too slow, due to over familiarity... Or... Whatever the medical language is for that! :)
 
2012-05-17 10:01:57 PM  
Bah, that stuff actually works on the horrid sinus infections I get. Fortunately, I don't take it often and just suffer with farked up sinuses most of the time.

Those are the antibiotics that actually worked, well except for the sulfonamides which work most excellently, but will probably kill me if I take them again.

/Yes, it's an allergy when your whole body welts up into hives and you can barely breathe.
 
2012-05-17 10:03:45 PM  

NewportBarGuy: Let's weigh the options. Trust someone to complete a 10-day course or a 3-day course... Hmmm...


Let me ask you a different question: how do you know this?

My dentist prescribes amoxicillin for me sometimes, and azithromycin for me at other times, and I just order the things, and eat up.

And while I try to walk through life as not a total dumbass, I don't even think to google the differences between two different antibiotics I'll use twice a year for dental cleaning.

But here is yet another FARK thread where everyone knows a shiat load more about this stuff than I do, and it turns out there are real differences and the information is useful to know, and yet, I want to refuse to believe I am a total dumbass.

Sigh.

/probably a total dumbass
 
2012-05-17 10:10:09 PM  
Harry Knutz: BronyMedic: Considering my day to day job includes regularly lifting 300lbs of dead weight with a baby inside of it

I'm listening.


Airborne Life Support System Isolette + 4 E Air and Oxygen cylenders + integrated monitor/defibrillator and bronchotron/phasitron ventilator integrated + Ferno Cot = 300lbs. Give or take between 500g and 5kg for baby.
 
2012-05-17 10:59:34 PM  

RoyBatty: NewportBarGuy: Let's weigh the options. Trust someone to complete a 10-day course or a 3-day course... Hmmm...


Let me ask you a different question: how do you know this?

My dentist prescribes amoxicillin for me sometimes, and azithromycin for me at other times, and I just order the things, and eat up.

And while I try to walk through life as not a total dumbass, I don't even think to google the differences between two different antibiotics I'll use twice a year for dental cleaning.

But here is yet another FARK thread where everyone knows a shiat load more about this stuff than I do, and it turns out there are real differences and the information is useful to know, and yet, I want to refuse to believe I am a total dumbass.

Sigh.

/probably a total dumbass


Nah, we're ALL staggering dumbasses, just about different things. If you ask me electrical, biking, or diving questions, I've got your answers. If you want me to compare and contrast the use of different antibiotics in patients presenting with a stubborn cough, that's not what I can do.
 
2012-05-18 04:03:14 AM  

Wenchmaster: Lovely.

I can't take Amoxycillin (several allergic reaction). I have a heart condition which requires me to take antibiotics before dental work. Guess what my dentist gives me? HINT: It ain't Amoxycillin.


1) amoxicillin****

2) I'm pretty sure this article doesn't hold much water, but if you're that concerned about it being detrimental to your health ask for something other than a macrolide- like a tetracycline (Doxycycline) or a cepholosporin (cephalexin). The cross allergic rates between penicillin based antibiotics and cephalosporins are pretty low (approx 3-7%) so it's not likely you'll have any reaction.
 
2012-05-18 10:06:49 AM  

Baumli: I'm pretty sure this article doesn't hold much water, but if you're that concerned about it being detrimental to your health ask for something other than a macrolide- like a tetracycline (Doxycycline) or a cepholosporin (cephalexin)


Why don't you think this article is valid? Being peer-reviewed, well-designed, and published in one of the top general medical journals, there's no glaring flaw. All it says is that five days of azithromycin leads to a tiny increase in risk of death from cardiac cause, mostly in those people who are already at highest risk of cardiac problems. So if there was someone with huge risks of cardiac diseases who needed antibiotics, it might sway the choice of antibiotics if there are other options and everything else is equal...but you're talking about a side effect that was found in 0.005% of patients who took azithromycin.

To summarize the article's main finding, it describes the detection of a very small risk of what is admittedly a horrible consequence... but pretty much all antibiotics (and all medications in general) have similar low-risk/high-consequence side effects. Amoxicillin can case kidney problems, seizures and varying degrees of rash all the way to loss of most of your outer layer of skin. Doxycycline can cause inflammation of the sac around your heart, esophageal ulcers, and raised pressure in your cerebrospinal fluid; and cephalosporins can cause many of the same problems as amoxicillin. None of them are very common, and usually they are hard to predict in advance.

/no, I don't own any stock in azithromycin... just stock in approaching things with common sense and an idea of what relative risks are.
 
2012-05-18 10:12:11 AM  

theMagni: CASB time:

So I'm getting a "Oh, I actually could have died..." out of these replies.

/Had arrythmia
//Heart output is 20% above normal
///Actually see a cardiologist
////35.


Ok asking a pharmacist about a medication and its possible side effects= yes
Letting a pharmacist DIAGNOSE AND TREAT you? NO!!!

/can I make the NO bigger? Please?
 
2012-05-18 05:06:52 PM  

lyanna96: theMagni: CASB time:

So I'm getting a "Oh, I actually could have died..." out of these replies.

/Had arrythmia
//Heart output is 20% above normal
///Actually see a cardiologist
////35.

Ok asking a pharmacist about a medication and its possible side effects= yes
Letting a pharmacist DIAGNOSE AND TREAT you? NO!!!

/can I make the NO bigger? Please?


Eh, I wasn't exactly up to full mental capacity. I'm lucky a homeless drunk wasn't walking past at the time.
 
2012-05-19 06:15:55 AM  

docmattic: Baumli: I'm pretty sure this article doesn't hold much water, but if you're that concerned about it being detrimental to your health ask for something other than a macrolide- like a tetracycline (Doxycycline) or a cepholosporin (cephalexin)

Why don't you think this article is valid? Being peer-reviewed, well-designed, and published in one of the top general medical journals, there's no glaring flaw. All it says is that five days of azithromycin leads to a tiny increase in risk of death from cardiac cause, mostly in those people who are already at highest risk of cardiac problems. So if there was someone with huge risks of cardiac diseases who needed antibiotics, it might sway the choice of antibiotics if there are other options and everything else is equal...but you're talking about a side effect that was found in 0.005% of patients who took azithromycin.
.


The point I'm making is this: azithromycin stood out, with 64.6 deaths per million courses... out of those how many were subject to abuse (mal-adherence)- this article is a media scare, look at the title: Popular Antibiotic May Raise Risk of Sudden Death, it's like a publication meant to encourage inappropriately filed lawsuits and fear among lesser educated individuals. In school we were taught 'every drug is guilty until proven innocent' and I stand by that clause, but it's not right to scare someone over a 1 in ~200,000 probability- yes it should be mentioned to patients, but not in a way that present's it as an inevitability.

in a warped sense, it makes me think of this: Link

But on a side note- not everything you read in a medical journal can be trusted- remember a certain article posted in the Lancet about 15 years ago? Yeah, THAT one. Not to mention the studies performed within marginally different parameters that post results on the verge of absolute polarity- anyone who's had source a presentation or paper will feel my disgust there.
 
2012-05-19 06:27:34 AM  

lyanna96: theMagni: CASB time:

So I'm getting a "Oh, I actually could have died..." out of these replies.

/Had arrythmia
//Heart output is 20% above normal
///Actually see a cardiologist
////35.

Ok asking a pharmacist about a medication and its possible side effects= yes
Letting a pharmacist DIAGNOSE AND TREAT you? NO!!!

Diagnose & prescribe: No. Treat: Yes, pharmacists already do that, it's in the job description.

/can I make the NO bigger? Please?

 
2012-05-19 08:34:51 AM  
Pt short of breath, diaphoretic, and chest pain, states he had recently been playing football and was tackled hard in the chest. EKG has P wave depression and, Xray shows pericardial effusion approx 500cc...

Pharmacist: How would you treat?



/man I'm farkin cranky.
 
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