Antibiotics Kill, Probiotics Heal


Two interesting studies were published recently.

First was a study in NEJM showing that the beloved ZeePack that so many people think will clear their boogers and resolve their cough instead increases the risk of death. During the 5 days that they took Zithromax (azithromycin), patients had almost a threefold increase in risk of cardiovascular death and almost a twofold increase in death from any cause. Patients who took Levaquin (levofloxacin) had the same increased risk of death as those who took Zithromax. The risk for death was significantly higher in patients who had preexisting heart disease.
Perhaps this may be related to the increase in death associated with higher patient satisfaction scores?
Also interesting that there was not an increase in death for patients using amoxicillin and Cipro. Makes me wonder whether “atypical” bacteria (which aren’t killed by amoxicillin or Cipro but are killed by Zithromax and Levaquin) provide some beneficial effect in the human body.

Which serves as a good segue to the second study.

A study in JAMA showed that probiotics significantly decrease the incidence of diarrhea that occurs when taking antibiotics.

I happen to be a proponent of probiotics for a number of medical problems. A couple of weeks ago I was offered the opportunity to review a new book about probiotics and will put up a review in the near future … when I finally get the time to read it.


  1. Correlation does not imply causation. Perhaps the people prescribed Zithromax or Levaquin were sicker? Also, did they study only enroll adults? Amoxicillin is used very commonly in children, which I would think would pull the numbers down there. Further, did it only include acute courses? I’ve seen Zithromax and Levaquin used as prophylaxis in both BMT and CF patients, both of whom are at higher risk of dying them the general population. I’ve never seen amox or cipro used for that purpose.

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