Azithromycin Increases Risk of Death Slightly... Well, So Does Tylenol and Ibuprofen

The media has made much fuss about a NEJM study suggesting a slight increased risk of death from taking azithromycin or z-pack. The more unhealthy you are, the higher the risk... no duh... (I would think the sicker you are, the greater the risk of death PERIOD... a sick person by definition is closer to death than a healthy person).

How slight? Compared to amoxicillin, about 47 additional cardiovascular deaths per one million courses of therapy.

Never mind the blatant biases found in the study nicely espoused on by cardiologist Dr. Wes in his blog.

Thinking you should never take a z-pack again due to this slight increased risk of death?

Well, good luck finding an alternative medication (of any kind) because they ALL have a potential risk of death.

Similar to z-pack, these other antibiotics also have an increased risk of sudden cardiac death:

• Avelox
• Bactrim
• Biaxin
• Cipro
• Diflucan
• Erythromycin
• Factive
• Floxin
• Foscavir
• Ketek
• Levaquin
• Sporanox
• Sulfa
• Tequin

It's not just antibiotics. These other common medications (not all-inclusive) also have an increased risk of sudden cardiac death:

• Benadryl (allergy)
• Pepcid (reflux)
• Albuterol (asthma)
• Prozac (depression)
• Serevent (asthma)
• Sudafed (decongestant)

The complete list can be found here.

Let's consider other popular drugs that also has an increased risk of death, though not necessarily from a cardiac trigger.

• ALL antibiotics due to a severe anaphylactic allergic reaction - Take Penicillin for example... about 300 die annually from penicillin allergic reaction in the US
• Tylenol causes liver failure - About 400 deaths per year in the US
• Ibuprofen causes internal bleeding - About 15,000 - 20,000 die per year in the US
• Alcohol related deaths - 75,000 deaths per year in the US
• Smoking related deaths - 443,000 deaths per year (one in five deaths) in the US

Never mind deaths from driving a car, accidental gunfire, drowning in a swimming pool, etc.

Life in general in the United States has a risk of death.

Source:
Azithromycin may up chance of sudden cardiac death. Heartwire 5/16/12
Popular Antibiotic May Raise Risk of Sudden Death. NYT 5/16/12
Azithromycin and the Risk of Cardiovascular Death. New England Journal of Medicine 2012; 366:1881-1890May 17, 2012

Can Eye Drop Medications be Used in the Ear?

Can EYE drop medications be used in the EAR for ear problems like ear infections?

For the most part, absolutely.

For pretty much any EAR drop preparation, there is an equivalent EYE drop preparation which can be used safely in the ear.

Why does this matter?

It's because it may be cheaper for the patient if the EYE drop medication is prescribed rather than the EAR drop medication. Often, it is not unusual for a brand name ear drop medication to be available in generic eye drop form.

NOW... EAR drop medications should NOT be used in the EYE because preservatives used in eye drop preparations are much gentler than those used in ear drops due to the eyeball being much more sensitive compared to the ear. As such, it may burn if ear drops are used in the eye... but not vice-versa.

• Floxin (Ear) equivalent to Ocuflox (Eye)
• Ciprodex (Ear) equivalent to Ciloxan (Eye) without the steroid dexamethasone
• Cipro HC (Ear) equivalent to Ciloxan (Eye) without the steroid hydrocortisone
• Cortisporin (neomycin-polymyxin-hydrocortisone) is available in both eye and ear preparations
• Tobradex (Eye) can be used in the ear and is imprecisely similar to Cortisporin (Eye/Ear).

Possible Cure for Common Cold And Other Viral Infections

For real... at least in mice, but has potential for human application if the promise holds out!

MIT researchers have developed a radical new approach to eradicating viral infections no matter what the virus may be... common cold, HIV, Ebola, polio, dengue fever, etc.

The usual anti-viral antibiotics in use today target the viral replication process which unfortunately often fails with time as the virus adapts and develops resistance to the medication.

The new medication dubbed "DRACO" (Double-stranded RNA Activated Caspase Oligomerizers) approaches viral infections using a totally different approach. It is able to IDENTIFY cells infected with the virus and KILLS the cell itself before the virus has a chance to take over the cell and create more virus copies. As such, the virus itself is not targeted, but rather the infected cells themselves instead.

To use an analogy, let's use an ant colony as the "viral infection". Current antivirals work by trying to pick off the Queen Ant or the ants themselves. DRACO works by destroying the entire colony. It doesn't care about individual ants or where they came from. All it cares about is the colony itself and initiates it's entire destruction.

For those more intellectually curious, DRACO is able to identify "double-stranded RNA" (ds-RNA) which is ONLY found in cells infected with a virus. One part of DRACO is able to identify and bind to this unique viral marker. The other part of DRACO is a protein that signals the cell to undergo suicide (apoptosis) thereby preventing the virus from hijacking the cell to make more virus particles. If a virus can't make copies of itself, no infection can occur.

Given ds-RNA is unique to viral infections, DRACO does not care what kind of virus it is (remember, it is not targeting individual "ants" to use the analogy). As such, whether it be the common cold or the dreaded Ebola virus, DRACO kills virus-infected cells indiscriminately. If no ds-RNA is present, DRACO remains inactive and healthy cells remain unharmed.

The tests reported in this study were primarily accomplished in cultured human and animal cells, but researchers also tested DRACO in mice infected with the H1N1 influenza virus. When mice were treated with DRACO, they were COMPLETELY cured of the infection. The tests also showed that DRACO itself is not toxic to mice.

More animal tests are underway and if all goes well... human trials may hopefully occur in the future!

Very promising!

Read a media report on DRACO here.

Reference:
Broad-Spectrum Antiviral Therapeutics. PLoS ONE 6(7): e22572. doi:10.1371/journal.pone.0022572