A pill for every ill is dangerous prescription
By Luis Fábregas
Published: Saturday, May 26, 2012, 12:37 p.m.
Every time she gets a cold, my old-fashioned mother heads to the doctor expecting a miracle cure.
Her family physician prescribes antibiotics and my mom, bless her hypochondriac soul, immediately feels like she's getting better.
I don't know if I should be more frustrated with her for being so gullible, or with her doctor, who is treating viral infections with drugs that will do absolutely nothing.
It is not surprising, then, that the relentless overuse of antibiotics is blamed for a surge in deadly, drug-resistant strains of bacteria. Yet many people choose to ignore that and instead clog urgent-care centers, doctors' offices and sometimes emergency rooms begging for antibiotics. They just don't want to leave empty-handed for their $100 bill.
In the old days, doctors would tell people to rest and drink fluids. Today, we ask for a "Z-Pak," the catchy abbreviation for Zithromax or azithromycin, an antibiotic used to treat bronchitis and sinus infections that's what Kleenex is to tissues. It's not unusual to hear people say, "I just started a Z-Pak. I should be better in a few days."
Doctors in the United States last year wrote more than 55 million prescriptions for Zithromax. That's about $464 million in sales just in this country. The Z-Pak is more expensive than other antibiotics but it's more convenient. You can finish a full course in five days, compared to 10 days for other antibiotics.
The overuse of drugs such as the Z-Pak fuels an alarming number of drug-resistant infections, according to Dr. Andrew Sahud, medical director of infection prevention and control at Allegheny General Hospital.
"The number of infections in the hospital, particularly in the ICU, is getting to a dangerous place," Sahud told me. One particular worry is the rise of bacteria resistant to carbapenems, a class of antibiotics used as a last resort for infections such as E. coli. "At any one time, we have several patients who are being treated with antibiotics that are the last resort."
Last week, the Z-Pak took a bit of a beating in the news when a study by Vanderbilt University in Nashville suggested the Zithromax antibiotic appears to increase chances for sudden, deadly heart problems in adults.
The study looked at 350,000 patient prescriptions for the drug. The results suggested there would be 47 extra heart-related deaths per 1 million courses of treatment with Zithromax compared with amoxicillin, another antibiotic.
Sahud told me the overall risk for most patients is low, which confirms what other doctors around the country were saying. Still, those of us who've taken a Z-Pak here and there paid close attention. Several people called my wife, who is a pharmacist, asking if they should be worried.
Doctors are running out of options when it comes to treating some nasty infections, Sahud said. In the hospital setting, for example, Zithromax is the most commonly prescribed antibiotic to treat community-acquired pneumonia. If there comes a day when we can't treat it with Zithromax, he wondered, what do we use in its place?
That's a great question for my mother's doctor.
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