Popular antibiotic linked to higher risk of heart disease death
May 16th, 2012
05:01 PM ET

Popular antibiotic linked to higher risk of heart disease death

It's one of the most popular antibiotics used to treat bacterial infections, but a new study suggests for some people taking azithromycin, commonly referred to as a "Z-pack", could be very dangerous.

Researchers at Vanderbilt University looked at the records of thousands of Tennessee Medicaid patients over a period of 14 years.  They found a 2.5-fold higher risk of death from heart disease in the first five days of using Z-pack when compared to another common antibiotic or no antibiotics at all.

The study was published in the current edition of the New England Journal of Medicine.

People with underlying heart problems seem to be especially vulnerable, says Wayne Ray, professor of Preventive Medicine at Vanderbilt and the study's lead researcher.

And while the risk is rare, it's important for doctors and patients to be aware.  At this point, Ray says it's unclear why Z-packs can cause heart issues.  He also points out that other antibiotics in the same drug class such as amoxicillin have been found to cause heart arrhythmia.

So should people with heart problems stop taking Z-packs?  Not necessarily.

"This just adds another 'con'," says Ray.

He says it's important to ask your doctor the follow questions:  How serious is the infection?  If I use a Z-pack could it aggravate any underlying health issues?  Are there any other antibiotics that could work just as well?

Ray says doctors often prescribe Z-packs because they only need to be taken for five days versus the 10-day periods that are typical with other antibiotics.

soundoff (10 Responses)
  1. 0,0

    anymore i guess doom is the new norm

    May 16, 2012 at 21:01 | Report abuse | Reply
  2. Dr. L

    Please fact check. You are scaring patients with false information. Yes, Azithromycin can cause something called QT prolongation which can lead to arrhythmias, however, amoxicillin is NOT in the same class! Amoxicillin is a penicillin derivative and Azithromycin is a macrolide antibiotic. TOTALLY DIFFERENT CLASSES OF ANTIBIOTICS. They treat similar infections through different mechanisms.

    May 17, 2012 at 06:38 | Report abuse | Reply
    • Dr. V

      It is ridiculous that something this egregious would be completely missed by the editorial process, especially on a point that the author is trying to use to drive home on the "danger" of an entire antibiotic "class"...it seems it is more important to incite fear in medications than it is to be responsible for checking facts

      May 17, 2012 at 11:36 | Report abuse |
  3. Sara

    Antibiotics are still way over prescribed. If you keep getting sick or infections such as ear, throat, sinus it is a clear sign that your immune system is depressed. You can correct this through natural means. If you get these infections frequently, check how much sugar and processed carbs you are consuming, probably too much. Save the antibiotics for the serious cases. Also, if you are using antibacterial soaps, then you should stop immediately and use regular fragrance free dye free soap.

    May 17, 2012 at 09:45 | Report abuse | Reply
    • J

      Not disagreeing, but it's not that simple. The academic answer is don't prescribe unless you are treating actual infection because of fear of ultimately increasing bacterial resistance. However the medical-legal conflict becomes, that 1:1000 patient that fails to overcome the infection by "natural means" and you "failed" to put pt on antibiotics initially, you might as well have signed the check. Sad but true but the lawyers feed on that stuff.

      May 17, 2012 at 12:23 | Report abuse |
    • MJM

      Actually it is just as simple as Sara says. The focus of all medicine should be to boost our own natural immunity. Z packs are WAY over prescribed. This is the first long term study and it shows an increased risk of heart disease. Most medications have never been studied beyond the few months it takes for FDA approval. There is a reason why America is ranked 37th in health care and it isn't insurance coverage.

      May 17, 2012 at 18:03 | Report abuse |
  4. Sharp

    I am thinking of making my doctor give any antibiotics by injection. Oral antibiotics can ruin your crucial gut flora. Even if they don't you may re establish with a badly balanced flora. Extreme cases have literally ruined patient's health. Yet another reason to NOT TAKE antibiotics unless they are really needed.

    May 19, 2012 at 00:07 | Report abuse | Reply
  5. Quickcheck

    Just so we're all on the same page here. Looking at the actual published report, the risk of cardiac related death while taking amoxicillin was 0.0000315%. With azithromycin it was 0.0000852%. Yes, statistically this is a 2.5 increase in relative risk. With the risk it's relative to being 0.0000315%. Is it what you would call a significant risk though? That's another question.

    March 13, 2013 at 16:05 | Report abuse | Reply
    • Dr. E

      Yes! Thank you for pointing that out. I was just reading through the study myself. Apart from what you mentioned, the study authors themselves admit their flaw in not controlling for certain cardiovascular risk factors, for instance obesity, smoking, and poor diet, which we know to confer an increased risk of sudden death from cardiovascular causes. Also, obviously, the increased risk of death from cardiovascular causes was most pronounced in those patients with a high baseline risk of cardiovascular disease. The initial statistical analysis cleverly failed to take that into account.

      March 13, 2013 at 20:50 | Report abuse |
  6. ThomasMt

    A-ONE OF P T H C

    January 13, 2015 at 08:19 | Report abuse | Reply

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