Thursday, May 24, 2012

Antibiotics and cardiovascular risk

I have had a few web site problems this last week. Every thing has been corrected

"Azthromycin and risk of Cardiovascular Death
published in the New England journal of medicine May 17, 2012

This is important to know about because  Azithromycin is part of a large class of commonly used antibiotics called Macrolides.

   Azthromycin  ( Zithromax, Z max )
   clarthromycin ( Biaxin )
   erthromycin    ( Eryc, ery-tabs )
   erythromycin ethel succinate
   fidaxomicin ( Dificid )

This article was reported that during 5 days of azithromycin  that here was a small absolute increase in cardiovascular deaths when compared to people who took no antibiotics or penicillin.
This class of antibiotics includes a caution in their prescribing information that it has the potential to effect electrical conduction in the heart in people with preexisting heart disease .

 This article supports the idea of being cautious when taking any new medication , even antibiotics, if you have known heart disease.

Have Fun , be Smart and make sure study any new medications and how it may effect your individual health situation. Read the package insert and discuss anything that is not clear with your doctor or pharmacist.

David Calder,MD


  1. Most people are unaware of side effects from prescribed drugs. They trust their doctor who prescribed them. How would a patient know if the doctor is looking out for their patient or commission from the sale?

  2. You are correct ," that most people are unaware of side effects from prescribed drugs ".
    This is something that needs to change. It is ok to trust but always verify . You and I as patients are ultimately responsible for our health care in office visit situations. Ask question about side effects , read package inserts . It does not hurt to remind your doctor about old medical problems. For example , Doc ,I had a problem with my heart about 10 years ago will this medicine effect that old problem?

    Regarding the commission idea. Doctors do not get commissions for prescribed medications , referrals . Most doctors do not prescribe medications based on drug reps.suggestions. Some doctors do own their lab and are reimbursed to cover lab cost.
    Thanks for your comment. David Calder,MD

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  5. Thank you for your comment. Every medication , over the counter , health food stores , pharmacies or from physicians has side effects and interactions with other medications and even some foods( like grapefruit juice ).

    Another somewhat hidden effect is the impact of a new medication on a forgotten pre existing health problem . The prescribing physician is focused on a specific problem and may not be be aware of /or has forgotten about an old preexisting heath problem that could be impacted by by the new prescription. A common one in my practice was steroid injections given by orthopedic surgeons to a person with diabetes. Diuretics can make postural hypotension worse and lead to increased risk of falls in older people.

    Keeping your own medical record history at your finger tips helps avoid this problem. Technology has made made us all a little bit safer. I hate to brag but Diabetes office visit App has an excellent risk management section that allows a person to keep their health history in their pocket.
    There are multiple drug interaction Apps available for smart phones , ipads. There are over 20 for the iphone and ipad. My favorite is Tarascon. Tarascon is a common pocket medication information source used by physicians and it has a good drug interaction section.
    your physician and pharmacist are good resources. your physician is your best source for of information about the impact of a new medication on a preexisting health problem.
    David Calder,MD

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  7. The researchers took many steps in this large, observational, population-based study to rule out other reasons for the increase in cardiovascular deaths in patients taking azithromycin.About 348,000 recorded prescriptions of azithromycin were compared with millions of similar records from people who were not treated with antibiotics or were treated with other antibiotics.Myoril Online The primary comparison was with amoxicillin, an antibiotic that is considered to be heart safe and is used in similar clinical circumstances as azithromycin.


Your comments and questions are appreciated. David Calder,MD