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4451049 tn?1387153437

Has anyone been given Azithromycin?

I don't trust Drs.  So when I'm prescribed anything at all, I will look further into it.  The FDA warns about the possibility of deadly heart rhythms with this medication.  They state that the "overall risk is low".  However, I do have some risk factors.  And after reading some of the reviews of individuals supposedly suffering life long heart related problems from this drug, I was somewhat reluctant.  I have an open mind when reading reviews and so I decided to proceed with caution.  I've been cautiously taking it for over a month now.  I listen to my heart from time to time, and I can certainly hear an arrhythmia when I breathe.  My lips are numb and I just don't feel right.  I don't want to question the Dr and I do want to get better, but I don't even think this medication has much benefit.  I could be wrong, so I'm not sure if I should stop the Azithromycin or continue.  Has anyone had any experience with this drug?

Thanks!      
32 Responses
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Avatar universal
If Flagyl were not of any use, then sure -- take it off the market.  But it has its uses, and it was necessary in my treatment for Lyme.  Risk/reward.
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Avatar universal
Short course is given because the half-life of the drug is 68 hours. That means that it takes 136 hours for this drug to completely leave your system. That's a week. It penetrates into the deep tissues and lasts for a very long time on even one dose. So a five day course lasts a week after the last dose and is cumulative during the five days.  In my opinion, that's just too dangerous a drug to be on the market, considering the long list of side affects.
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Avatar universal
Short course of one or 5 days is given because the half-life of the drug is 68 hours. That means that it takes 136 hours for this drug to completely leave your system. That's a week. It penetrates into the deep tissues and lasts for a very long time on even one dose. So a five day course lasts a week after the last dose and is cumulative during the five days.  In my opinion, that's just too dangerous a drug to be on the market, considering the long list of side affects.
Helpful - 0
1763947 tn?1334055319
I was given a rotation of Flagyl, every 2 weeks from the start of treatment. Some people take it 3 times a week. From what I have heard from my other support groups and Lymie friends, they all take either Flagyl or tindamax.

You should ask your LLMD because it's important. Since I do the every other 2 week cycle, I usually herx when I start the Flagyl again. I also change abx every quarter or if I feel nothing is happening.
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4451049 tn?1387153437
I was wondering why I wasn't given a cyst buster such as Flagyl.  I figured there must be a reason.  Maybe I'll ask next time.  I think maybe it's used later on in treatment, but IDK.  It seemed senseless from the very beginning to be bombarded with all these antibiotics and nothing to attack the cystic form.  I have no clue what the Drs plan is.  All I know is that I don't want an antibiotic resistant superbug from taking all these antibiotics.  That's why I'm sort of interested in pulsing.  
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Avatar universal
PS when I said tell them where you live, I mean what city or near what city/metro area.
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Avatar universal
"I took it [azithromycin] orally and IV- did OK for 2 years then relapsed badly. It might have drove it temporarily into cyst form or it missed the ones encased in biofilms"

That is consistent with my understanding.  What did your doc say, or better question:  have you seen a new Lyme doc?  I would.  Let us know if you need help finding one, or email to

                            ***@****

(If the bot blocks the URL, it is:  contact   [at]    ILADS   [dot]   com]

and tell them where you live and how far you can travel.  They will send you names of ILADS members nearby.  There is no test to join ILADS, so some of the docs may be a bit far out there, and if you get a dud, go back to ILADS and request another name.  
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Avatar universal
While on the IV there was one other antibiotic but no flagyl. They thought I had pneumonia while it was pulmonary embolisms
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Avatar universal
Was the azithromycin paired with something like Flagyl/metroniazole?  Without Flagyl etc. to break through the cysts the bacteria hide in, the 'zith' isn't able to reach the bacteria.
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Avatar universal
I took it orally and IV- did OK for 2 years then relapsed badly. It might have drove it temporarily into cyst form or it missed the ones encased in biofilms
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4451049 tn?1387153437
I thought pulsing sounds interesting and something that may be very effective, but it'd probably have to be done right for it to work.  
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Avatar universal
Perhaps if the full-on approach doesn't work, even if using cystbusters to break through the biofilm, then pulsing may have an effect, but I don't know on what basis.  Full-on worked for me, so I didn't explore pulsing.
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Avatar universal
It's good to be skeptical. I am. But because I'm skeptical I rarely believe in  any one er, um belief or stance. Doctrinairism is too, er, um, constricting. (grin)

Hassler, 199145 -reported on two patients with antibiotic resistant Lyme disease that were treated with pulsed high-dose cefataxime with 2 days of treatment followed by 6 days without antibiotics over a ten-week period of time. One patient was symptom-free 6 months after antibiotic treatment, the other was improved and skin biopsies showed no evidence of Borrelia."

Some doctors maintain that pulsing with antibiotics (often IV but also often oral) BECAUSE of the slow growing nature of Bb will provide the patient with the same efficacy as the continuous taking of antibiotics; that not coninually 'blasting' us with antibiotis kinder and  yet still accomplishes as much.

Dr David Martz pulsed repeat bouts of antibiotic/antibabesial therapy after continuous tx before. He's the doctor who was given an ALS dx but then went on to treat for Lyme (with the help of his colleague, Dr. Harvey in CO.)

Other doctors don't follow that thinking. But----- what can WE think when experts exist on both sides?
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Avatar universal
Never really looked into pulsing.  The concern about killing the weakling bacteria and letting the stronger ones survive to become antibiotic-resistant is what makes me skeptical.  And the full frontal assault on the bacteria worked for me, so I didn't need to pursue other approaches.
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Avatar universal
"No, and my doc didn't 'pulse.'"

My llmd didn't pulse either. I just thought you might have some thoughts on pulsing. If you ever do, would you post them, please?
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4451049 tn?1387153437
Thanks cave!  

Yea I know it does seem like that question is specifically asked a lot, but I can't say I have much of a medical history to compare. So I don't really know.  I can definitely understand why that would be so important for a dental office to know though.  

My BP was checked in the office and it was prehypertension then, so IDK if that should have been a red flag or not.  

No, I can't say for certain that I have had other herxes.  I think that's what makes it so much more confusing.  We don't even know if I have Lyme and/or cos yet, so I've been trying to decipher and I really can't tell.  
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Avatar universal
No, and my doc didn't 'pulse.'
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Avatar universal
Jackie, you asked:
"Looks like Zithromax can be given in short courses with no danger of antibiotic resistance."

On what do you base that conclusion?  That the dosing schedule is only a few days in some situations?  "

I based that conclusion from Pfizer's (the manufacturer) site about Zithromax:
http://labeling.pfizer.com/ShowLabeling.aspx?id=511

-----And from hundreds of other places, some personal accounts and some other valid sources. Wiki was one, but I usually go to their citations to find their sources.

Here's what Pfizer had to say:

DOSAGE AND ADMINISTRATION

Adults:
Infection* Recommended Dose/Duration of Therapy

*Community-aquired pneumonia (mild severity)
*Pharyngitis/tonsillitis (second line therapy)
*Skin/skin structure (uncomplicated)

500 mg as a single dose on Day 1, followed
by 250 mg once daily on Days 2 through 5.

*Acute bacterial exacerbations of chronic
obstructive pulmonary disease (mild to moderate)

500 mg QD x 3 days
OR
500 mg as a single dose on Day 1, followed
by 250 mg once daily on Days 2 through 5.

*Acute bacterial sinusitis 500 mg QD x 3 days

*Genital ulcer disease (chancroid) One single 1 gram dose

*Non-gonoccocal urethritis and cervicitis One single 1 gram dose

*Gonococcal urethritis and cervicitis One single 2 gram dose

*********************************8

One gram = 2 of the 500mg Zithromax tablets

I did find your explanation about antibiotic resistance interesting and could be right on the mark considering the long replication time of Bb.

I haven't had the time to think about how pulsing antibiotics (which has been promoted by many doctors but also decried by others) factors into the 'resistance' arena.

Dr J, the famous llmd in D.C. whose treatment protocol includes pulsing, said this:

" we have concluded that a treatment protocol employing long-term cyclic, pulse therapy with drugs effective against all forms of the organism might be effective"

I won't give the link because his name is on it.

Do you have an explanation for pulsing being safe?




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Avatar universal
Ephedra said:

" It didn't specifically ask if I have a family history of heart disease though. "

That's odd, since, as far as I can remember, that has always always been on my med. histories. When I was a dental hygienist it was even on the intake history in my dental office and then the med hist. (not just the heart)  rechecked each time the patient came in!

There are other antibiotics that can help you. I can't begin to think what caused the severe reaction you had; Herx? Allergic reaction? Heart problems? But I  do think you did the right thing and I would have done the same thing.

I assume you've had other 'herxes'---- did any of them affect you like that?
Helpful - 0
Avatar universal
I sent you a 'private message' through this system ...  the gist of it being to be careful and check with the doc if you are having symptoms that feel like more than they ought to be.  Take care --
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4451049 tn?1387153437
Cave, there was a family history section that I honestly filled out at the beginning.   And yes, there should have clearly been red flags.  It didn't specifically ask if I have a family history of heart disease though.  

Your right Jackie, I didn't want to quit the medication because I know how bacteria become immune.  However, it got to the point that I thought my life was seriously in danger.  I couldn't walk without the feeling of my heart going erratic and feeling like I was going to puke and collapse.  My bp was high.  I think I'm a little better today, but I haven't been moving around much either.  Nobody would be around to help had I collapsed.  

Drs are sometimes hard to get ahold of and most of them don't really know what they are doing anyhow.  Maybe I'm just paranoid, but I'm not going to allow anyone to be in charge of my life.  And for the same reason, I won't get in a vehicle when someone else is driving.  I think maybe it's the fear of being in a vegetative state more than it is the fear of death.  

I really really didn't want to stop taking it, but what would you have done if you were in this situation?  

Thanks everyone :)
Helpful - 0
Avatar universal
"Looks like Zithromax can be given in short courses with no danger of antibiotic resistance."

On what do you base that conclusion?  That the dosing schedule is only a few days in some situations?  

Different ailments call for different treatment times even if the same antibiotic is used, due to the susceptibility  particular of the bacteria to that particular antibiotic.  Susceptibility of a particular strain of bacteria is based partly on the length of its reproductive cycle, because it is when dividing that bacteria are most susceptible to antibiotics.  

Azithomycin/Zithromax may be given for a week for an ear infection, but is given for months in the case of Lyme, because Lyme bacteria have a very slow reproductive cycle, compared to the usual bacteria involved in an ear infection.

Failing to take the full dose for the full length of time prescribed risks treatment failure and creation of antibiotic-resistant strains of bacteria which were merely weakened rather than killed, allowing them to flourish rather than die.

If you are driving from California to Florida, you will be in the car for several days.  If you are driving from California to Nevada, you will be in the car for several hours.  If you stop driving after several hours, you will not get to Florida, because it requires travelling a greater distance.  That's just the way it works.  Ditto meds.
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Avatar universal
" With the "Z-Pak", this means two 250-mg tablets (a total of 500 mg) on the first day and one 250-mg tablet once daily for the next four days."

" 500-mg tablets are commonly available commercially in a pack of three tablets, or "Tri-Pak,"

"Azithromycin is commonly administered in tablet or oral suspension (a one-dose version was made available in 2005)"
[Often given when someone has had unprotected sex and fears an STD]

Looks like Zithromax can be given in short courses with no danger of antibiotic resistance.
Helpful - 0
Avatar universal
Every medication, and indeed everything you put in your body, has the potential to harm for all kinds of reasons.  Riding in a car can kill you if it crashes, but we're not banning cars.  There is always a risk/reward balance with everything.  

It is the responsible and necessary thing for drug companies and others to notify the authorities and the public if a new risk is found in the use of a medication, often a risk that didn't show up in early testing and early use.

When used by a large population, however, there are many more data points, and if the adverse results in the larger population show a trend that wasn't evident in the smaller test population, then it is the right (and required) thing to do to notify the medical community and the public.

It doesn't mean the drug is bad or useless or will harm everyone who takes it.  It means that with more experience in the population, trends are seen that were not noticeable in smaller user groups.

I can understand why you would want to stop taking something that has a bad report come out.  There is a risk in stopping medication, however -- it can give the weakened bacteria a chance to survive and reproduce and be immune to the action of that drug ... which can makes the drug eventually useless for not only you, but for everyone, if the surviving strains are no longer susceptible to that drug.  

I would always check with my MD before stopping antibiotics.
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