Consultant has prescribed azithromycin to be taken every three days because I did say I had an exacerbation two years ago, although I am not sure it actually was. Also this entails undergoing three ECGs a month apart. Don't like the sound off that. I also suffer mild bronchiectasis, so I suppose I am more venerable to pneumonia in this cold weather.
Is it worth risking an Afb episode and possible heart problems by taking the azithromycin.
Totally understand this is a medical question but would still welcome thoughts, especially from those taking this antibiotic.
Lots of good wishes to all.
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Frustrated12
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Azithromycin is an antibiotic. You don’t say why it was prescribed. I assume it’s because you have a high risk of pneumonia or you have a low grade chronic infection. If so, how bad would pneumonia affect your heart?
I don’t know if this antibiotic could affect your AF but a serious infection would probably be more risky. It’s all about weighing up the relative risks. The do-nothing option doesn’t necessarily mean zero risk, so you need to give that as much consideration in making your decision.
I’m not a fan of taking antibiotics unless necessary, but sometimes they are necessary and even lifesaving. So I suggest you talk this over with your GP or specialist if you can’t decide what to do for the best.
Thank you for that. Good, sensible reply, in my opinion.
Azithromycin was prescribed after I told the consultant that I had suffered an exacerbation of my bronchiectasis. In effect, it was more likely to have been a bad lung infection. He was obviously trying to reduce my chances of getting pneumonia with any exacerbations.
However, Azithromycin, I understand, is not recommended for people with heart problems. Am I right in thinking Afb is a heart problem? Which is the reason for the ECGs, I suppose. To ensure my ticker is ticking ok.
Best I follow the original advice e and start the antibiotics (three times a week throughout the winter) and have a chat with the GP as well.
Yes, AF is an heart arrhythmia and not to be taken lightly, I’m afraid.
There are different antibiotics but you’d need to discuss this with your doctor as some may be better for lung infections than others. There’s also a big problem with antibiotic resistance and that may also be affected by your own history of antibiotic usage. (I learned about this when my h pylori treatment failed — these bacteria are getting too clever at dodging the drugs now.)
I don’t like taking antibiotics at the best of times, but I had to take a course a couple of months ago and thankfully they worked.
Thank you again. The consultant just shook his head when asked about antibiotic resistance. As you indicate - risks v benefits. Hope your week goes well and of course all others in this wonderful support group.
I have a history of antibiotics not clearing infection, the h pylori was particularly upsetting because that regime was quite brutal on the system, and after all that it failed anyway. The GP’s surgery insisted I had to have my urine tested for AB resistance before I could have a prescription issued and then checked afterwards to make sure it had cleared, Thankfully it had. As for h pylori I was referred for an endoscopy because they wanted to take a biopsy and test which antibiotics would work but I haven’t been able to face all that. I’ll get round to it one day but it’s just too much to deal with right now, as I’m still battling with post-Covid fatigue and the damn Covid kicked off AF, so…. It never rains but it pours, eh? Stay well.
I'd suggest that you contact the Consultants office and leave a message with his Secretary to call you back because you have AF and you are concerned about taking Azthromycin because it isn't recommended with your heart condition and ask if they can check if there is another antibiotic that you can take instead.I assume your Consultant did some checks on the progress of your bronchiectasis as decided it was necessary for you to begin the antibiotic protocol because you are more at risk of pneumonia or bronchitis than you were before.
I know in most cases generally healthy people have more restrictions on using antibiotics for fear of them causing antibiotic resistance, but there are certain illnesses , like yours , when long term antibiotic use is used as a preventative and the benefits of taking the antibiotic most of the time outweigh the risk of building up resistance to it.
I would hope your Consultant has also taken into consideration that the risk of the antibiotic causing an episode of aFib is much lower than the chance of you catching pneumonia and being ill from that , which could trigger AF as well in their decision to try this out.
It would probably also be worth contacting whichever Cardiologist or Cardiac. Hotline you have locally and explaining your situation and asking for their opinion on this. It would be reassuring for you to know if the Cardiologist believes that it would be ok in your circumstances to take Azthromycin despite the possible side effects or if they would suggest a different antibiotic.
And of course check with the GP too, although they may be at a bit of a loss in this situation and consideration it's better to just follow the Consultants advice.
I feel for you , as a person with a number of chronic health problems I know how hard it is sometimes when the medical needs for one problem could cause the other ones to flare and how many questions and checks you need to do before you start a new medication to try to prevent those flare ups happening.
What they may have considered is that as you are on the long term method you don't take the antibiotic every day ,or at such high doses as you do when you take a course to treat an active infection, so the amount taken per day may make it less likely to cause a heart problem as a side effect.
But that's only a speculation on my part , this is a serious medical question so it really needs dealing with by talking it through with the Specialist and both of you making a decision from there.
Have you been having more problems from the bronchiectasis this year or have they found more weakness in your lung capacity than before?
Having been prescribed meds by my GP which interacted with another I was already on,resulting in extremely low blood pressure dizziness & double vision! I am NOW very cautious. Check online for any interactions & don't be afraid to ask other professionals for their input. Best wishes.
In the first instance ask your dispensing pharmacist - he knows more about interactions than most Docs do and it will probably be easier to contact him than your consultant but do definitely call your consultant too and ask . Whether it was a lung infection or an exacerbation of your bronchiectasis then it would still need treatment and some preventative measures being taken top avoid further, longer or worse problems where possible. With your respiratory problems the risk is probably higher to you from a lung infection which in itself would affect your AF but always best to clear things up and ask professionals about this.
The timing between when the ventricle contracts and when it relaxes is called the "QT" interval. This can be measured on an ECG. As a side effect, some drugs can extend this interval, and in some people's hearts, it is already naturally prolonged, thus bringing worry to doctors to give those people drugs that are known to extend it further.
Azithromycin appears to be one such drug. The risk is that there's a link between prolonged QT interval and ventricular (not atrial) arrhythmias, which can, if prolonged, require emergency treatment. From what I have read, it's an imprecise area and the risk isn't easily quantifiable.
I must have this as I can't take flecainide or sotalol, two anti-arrhythmic drugs that can prolong the QT interval. In your case, I am sure that your doctor must be satisfied that the azithromycin is safe.
Hi Frustrated 12 - first of all I must say we are all different and can respond differently to medication. However, I have Bronchiectasis and Paroxysmal AF. I have been taking Azithromycin 3 days a week for several years (for colonised pseudomonas), increasing to 5 when required. I also take Flecainide and Adizem for AF and, for me personally, I have had no ill effects whatsoever from taking these drugs and no increased AF episodes or heart problems. My heart consultant and chest consultant do talk to each other which is useful, but again, as far as I am concerned, if there was a problem with drug interaction I'm confident the necessary precautions would have been taken. If you are concerned, maybe discuss it with your consultant. Good luck and keep well and safe.
I have taken two courses of azithromycin within 4 months with no issues whatsoever. My concern with taking new meds is always whether I will have an allergic reaction, never that my doctor or pharmacists will allow me to take something that would affect my AF.
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