The Dr. B Health Blog

A study with azithromycin (you all know the famous Z Pak or one of the brand names Zithromax) showed a slightly higher rate of death among adult patients taking the drug compared to those on other antibiotics. (There have been other studies suggesting dangers to children as well by the way.)

The U.S. Food and Drug Administration (FDA said it was aware of the study, which was published in the New England Journal of Medicine, comparing Zithromax to Bayer's Cipro and Johnson & Johnson's Levaquin.(Neither of these drugs are without serious side effects as well by the way.) Pfizer's Zithromax showed a slightly higher rate of death due to heart complications- sudden death that may be associated with an altered heart rhythm.

All drugs can and do have serious side effects. Sometimes they are necessary evils. Most doctors prescribe medications and certainly antibiotics far too quickly. I have a bunch of patients that say they need antibiotics because they have been sick “for a while” or their previous doctor would always prescribe it when_________________________ (fill in the blank- “I had a sinus infection in the Fall, Spring, Summer, Winter”; “I had a sore throat like this one every year around this time”; blah, blah, blah…..). When I speak about the possibility of drug resistance and that we could be contributing to resistant strains, they typically could care less in that it is too abstract and they do not believe that this will directly affect them! Now if they (you?) demand an antibiotic- know that one might suddenly drop dead from the antibiotic that probably was not really needed anyway. I will duke it out with a viral sore throat using salt water gargle and some tea and honey rather than take an antibiotic that could kill me and will not treat the virus anyway. You? Here’s the prescription pad.........................................

Drug-testing welfare recipients costs more money than it saves

By Alicia Caldwell
Editorial Writer, DenverPost.com

I can't say I was surprised to see this New York Times story conclude Florida gleaned no savings from drug-testing welfare recipients.

In fact, after benefits savings and drug-testing expenses were accounted for, the policy ended up costing Florida's state government nearly $46,000.

1. As if there is ANY reason to take this stuff, Isotretinoin, which goes by brand names  Roaccutane, Claravis and Amnesteem (and used to be called Accutane), is already and indisputably known to have serious side effects, such as delays in bone growth in adolescents and spontaneous abortions in pregnant women. Now this drug that should be off the market and which is used to treat cystic acne has been linked to an increased risk of eye problems such as pink eye, styes, and dryness. The data is from a large Israeli study and reported in Archives of Dermatogy on line.
2. The manufacture, Roche says that 16 million people around the world have used this product. But, in this Israeli study 14% of those that used the drug within the first year required treatment for an eye condition.(I should point out that people with acne do have a higher incidence of eye conditions, but, nowhere near this number)!

Amazingly, instead of saying do everything you can not to have a loved one take this drug unless it is the LAST resort, one of the authors advises people to have users’ eyes checked every 3 months!Acne can be terrible.  I am not downplaying really bad acne, but there are other options- lots of other options that should be considered first. Let’s explore those in future installments. In the meantime, STAY AWAY FROM THIS DRUG. It’s dangers are MORE THAN SKIN DEEP!!!!!!

Having been a battered child, I have known depression. Often alone, and with no support, I wondered if there was any reason to live. Somehow, I survived at a time when seeing a therapist was a luxury I could not afford and my general practitioner did not even prescribe antidepressants. Why and how I made it is not germane to this blog entry. A day does not go by that I do not remember the despondency and while I wish that I did not have to undergo the anguish, surviving gave me strength that has carried through to the present.

I do not want to sound macho or callous, but sometimes our personal pain leads to personal strength. For me, it has led to a real appreciation of the happiness and joy I feel every day being alive, seeing my wife and children and enjoying what I do as a physician. I am not saying that depression is a good thing, but sometimes its’ contrast with “normal” life builds depth of character and we may be better for it. Clearly, the degree of depression may merit the kind of help that one might get from a talk therapist or from anti-depressants. But, I do believe that we are too quick to seek out drugs when we feel sad, challenged, or anxious. Sometimes, one might just want to wait a bit and try to work things out from within. It’s that same “quick fix”- “I can’t stand the pain.” that has made us so dependent on prescription pain medications like the opiates.

In my practice, I do see folks where an antidepressant is indicated for short or long term relief. When I can, I try to recommend over the counter SAMe (S-Adenosyl Methionine) which may be quite effective and has a great safety profile with few side effects. It’s important to get individually wrapped SAMe because it degrades quickly in light and the tin foil protects it. The biggest problem is cost. It’s not cheap, so often my patients will elect to use a prescription antidepressant because the copay is cheaper than buying  SAMe. True, but, the SSRI’s, SSNI’s, etc. have much more disturbing sides effects. While I have not had cause to use an anti-depressant, were I to require one- really require one- I would go with the safest choice first- SAMe.

Here is yet another reason why you need to REALLY be thinking hard about why you are getting and/or why you are demanding antibiotics from your health care provider.If you have been listening to my radio show, or following my blogs, you already know that we are all in great danger because of the unnecessary prescribing of antibiotics. Also, the wanton use of antibiotics in animals (agriculture) have both  contributed to microbes (germs) that are COMPLETELY resistant to antibiotics. Thousands have died this year in Australia as a result of resistant germs and this  frightening story is being replicated around the world. Yet, I still meet patients in my office who ignore this because 'THEY" really "need" the antibiotic. Just yesterday one of my patients told me that Cipro ( a commonly prescribed antibiotic)  works for her "all the time" when she has a bronchitis (Which, by the way, is typically a virus that does not require antibiotics). Her previous doctor would prescribe it over the phone because he "knew her"!

Well, let's see if this new research will make you Cipro users think twice and maybe you might wonder if all antibiotics carry more than the copay as a price tag you hadn't thought about.

The fluoroquinolones class of antiobiotics (Ciprofloxicin, Zoxan,Proquin, Levaquim and Cravit) seem to increase your risk of detached retinas. The retina is necessary to see. It receives light and "transmits" it to the brain. We already know that the fluoquinolones affect the Achilles and shoulder tendons. When I was placed on Cipro many, many years ago for a demonstrated infection, it effected my soft tissue for  almost a year- of this I am certain. My Achilles was stiff and luckily it did not snap. Fortunately, my eyes were not effected. The retina effect is highlighted by the fact that those showing up for emergency diagnosis and treatment of a detached retina in opthalmology offices and emergency rooms were 5 times more likely to be taking this class of drugs. Remember that this is a SERIOUS complication whereby the patient could lose their vision in that eye!