Can I Get a Z-Pak With That?

a doctor's prescription pad
Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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“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:

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

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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