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Can I Get a Z-Pak With That?

by Dr. Sharon Orrange on July 5, 2012 at 12:38 pm

“Can I get a Z-Pak?” is a question asked every day by our patients struggling with an upper respiratory infection. Trust me, I want to help you get better but that’s not always the way to do it.

The “Z-Pak” (a five-day course of azithromycin) is often prescribed because of its ease of use and because there isn’t much known bacterial resistance to azithromycin. It is important to know that we are guilty of overprescribing and overusing these for infections that are often viral. There may be a new downside you should know about before you ask for your Z-Pak.

Last month the Food and Drug Administration (FDA) issued a statement concerning the safety of the antibiotic azithromycin (Zithromax) and a possible increased risk of cardiovascular death. Here are the details:

– Results of a recent study showed a small increase in cardiovascular deaths, and in the risk of death from any cause, in persons treated with a 5-day course of azithromycin compared with persons treated with amoxicillin, ciprofloxacin, or no drug.

– The FDA plans to communicate any new information on azithromycin and the potential risks after it has completed its review.

– The FDA is reminding doctors to be aware of the potential for QT-interval prolongation (change in heart rhythm) and cardiac arrhythmias when prescribing or administering azithromycin.

If you are suffering from an upper respiratory infection here is what you need to know:

– You are going to feel lousy for several days because you have an upper respiratory infection (URI), also known as the common cold.

– You may never know which virus you have. Many different viruses can infect the tissues lining the upper respiratory tract.

– Symptoms vary but include runny nose, sneezing, nasal congestion, sinus irritation, sore throat, laryngitis, or cough. Fatigue, muscle aches, headache, and low grade fever may also occur.

– You may diagnose your own upper respiratory infection based on familiar symptoms, since most people get a cold 2 – 3 times a year.

– Most people improve within a week, but symptoms can last two weeks. A residual cough may last a week longer.

– Treatment is directed at relieving symptoms.

– There is no cure.

– Antibiotics are not effective. In fact, improper use of antibiotics can lead to the development of drug resistant bacteria which we all hate.

What does help for an upper respiratory infection? Increase fluid intake, and inhale heated mist or steam (from a vaporizer or shower). Get plenty of rest and use gargles or lozenges for comfort. Zinc lozenges, taken in the first 24 hours of symptoms, can shorten the duration and lessen the severity of symptoms. Pain medications (acetaminophen or ibuprofen) may help fever, muscle aches, and throat pain. A variety of non-prescription medications are available to treat congestion and runny nose (loratadine or Sudafed). If you don’t get better your doctor may suggest nasal or lung inhalers for other symptoms.

Now, there are times you should seek immediate medical care. If you develop a temp above 101° F or if your fever lasts more than 2 days you should be seen. We’d like to see you if you develop severe or persistent headache, ear pain, sinus pain, or chest pain. Also let us know if you develop a prolonged cough, cough up blood, or develop wheezing.

Hang in there.

Dr O.

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