Daily zithromax, prophylactively?

[tsm007]

I just discharged a patient and was going over his new meds that were listed on his discharge paperwork. One of them was zithromax. He then tells me that it was not new he's been taking it for months. That his doc has him on it to keep him from getting sick. To be honest I didn't believe him because he'd given me some misinformation already about his home meds. So he pulls out some paperwork from his doctor (or pharmacy can't remember), but sure enough it had zithromax listed. Can someone explain to me the rationale on long term use of antibiotics? I just had never heard of that before. I feel like I learn something new every single day lately.

[jadelpn, LPN, EMT-B]

There are people who have chronic stuff (UTI's comes to mind) that do take one antibiotic a day as prevenative measure. It is really old school, and rarely see that now.

But Zithromax is so long acting well after one finishes a classic "z-pack" that I am curious as to the goal of this treatment. With the cardiac concerns that could come from this medication, not sure worth the risk. Not well learned in it, but c-diff from long term antibiotic use is also a concern, as well as Zithromax is pretty strong stuff--what happens when resistance happens?

Does this patient get chronic UTI's? Perhaps has had a tick borne disease that they are getting long term treatment for (which sometimes can last for months)

I think you need to find out the reason Zithromax is being taken long term.

AZITHROMYCIN

Interesting, apparently this is common for patients with different strains of gram negative yucky stuff.....

[tsm007]

There are people who have chronic stuff (UTI's comes to mind) that do take one antibiotic a day as prevenative measure. It is really old school, and rarely see that now.

But Zithromax is so long acting well after one finishes a classic "z-pack" that I am curious as to the goal of this treatment. With the cardiac concerns that could come from this medication, not sure worth the risk. Not well learned in it, but c-diff from long term antibiotic use is also a concern, as well as Zithromax is pretty strong stuff--what happens when resistance happens?

Does this patient get chronic UTI's? Perhaps has had a tick borne disease that they are getting long term treatment for (which sometimes can last for months)

I think you need to find out the reason Zithromax is being taken long term.

AZITHROMYCIN

Interesting, apparently this is common for patients with different strains of gram negative yucky stuff.....

That was an interesting read. Thanks.

Chronic use of azithromycin is used to treat atypical mycobacterial infections and as prophylaxis against common bacterial infections in highly susceptible persons (with cystic fibrosis, chronic granulomatous disease, or brochiectasis).

All he said was the doc gives it to him to keep him out of the hospital. He was there for COPD exacerbation so maybe there's something to that. I don't know. It clearly didn't keep him out of the hospital though.