Both of these drugs are used all the time by doctors. You may know macrolides as azithromycin (Z-Pac), zithromax, and clarithromycin (Biaxin). And the most commonly used quinolones are ciprofloxacin (Cipro) and levofloxacin (Levaquin).

To find out just how often these drugs cause cardiac arrest and death, researchers used a remarkably simple investigative approach. Here's what they did. They looked at the records in several hospitals for cases of ventricular arrhythmias or cardiac arrest. Then they found 10 other patients who went to the hospital at the same time who were the same age and sex, but who had problems other than an arrhythmia. Then they looked at how often the patients with the arrhythmias had taken any macrolide or quinolone drugs before they developed the problem compared to the patients without arrhythmias. The results were enough to make you really think it over the next time your doc prescribes you one of these antibiotics.

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All in all, the researchers looked at 1,275 patients with the arrhythmias and 9,189 patients without them. The arrhythmia patients were up to 3.39 times more likely to have had a macrolide antibiotic. And they were up to 3.58 times more likely to have had a quinolone. Their conclusion? "Three observational study designs each using entirely different sets of controls consistently showed that the recent use of macrolide and quinolone antibiotics may be associated with increased risk of ventricular arrhythmia and cardiac arrest." Now here's why this is so important.

If you think that we doctors really know what the drugs we dish out are doing in our patients, you need to think again. Sure, we know what their mechanism of action is. But it's impossible to account for every single possible reaction that can go wrong in each patient because every patient is completely different. To add to that, very often when patients are prescribed drugs, they are also taking other drugs. And while the expected reactions that happen with each drug can be anticipated, the reactions that come with combinations of drugs are completely unknown. We actually have no idea what's happening in that case. This is no doubt one of the reasons why the medical use of drugs is one of the leading causes of death in the U.S. And it's why this is so important to only use drugs when nothing else will do.

So please find a practitioner for yourself and your family who is familiar with alternatives to drugs. The truth is that most drugs are not needed. I have a full-time general medical practice. I see all kinds of infections from pneumonias to ear infections to cellulitis — whatever comes down the pike. But despite this, I have to rely on antibiotics no more than once every two to three months. Compare that to many of my drug-only colleagues who prescribe them 5-10 times a day!

Yours for better health,

Frank Shallenberger, MD

REF:

Zambon A, Polo Friz H, Contiero P, et al. Effect of macrolide and fluoroquinolone antibacterials on the risk of ventricular arrhythmia and cardiac arrest: an observational study in Italy using case-control, case-crossover and case-time-control designs. Drug Saf. 2009;32(2):159-67.

http://www.medpagetoday.com/Cardiology/Arrhythmias/32725.