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Deadly ebola outbreak in Ugandan capital

"A Ugandan health official wears protective gear as he deals with an ebola outbreak at the Bityo hospital in 2007. Uganda's president has warned against shaking hands and other physical contact after the first reported death from the deadly Ebola virus in the capital Kampala. (AFP Photo/)" title

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Antibiotic linked with rare but deadly heart risk

An antibiotic widely used for bronchitis and other common infections seems to increase chances for sudden deadly heart problems, a rare but surprising risk found in a 14-year study.

Zithromax, or azithromycin, is more expensive than other antibiotics, but it's popular because it often can be taken for fewer days. But the results suggest doctors should prescribe other options for people already prone to heart problems, the researchers and other experts said.

Vanderbilt University researchers analyzed health records and data on millions of prescriptions for several antibiotics given to about 540,000 Tennessee Medicaid patients from 1992 to 2006. There were 29 heart-related deaths among those who took Zithromax during five days of treatment. Their risk of death while taking the drug was more than double that of patients on another antibiotic, amoxicillin, or those who took none.

To compare risks, the researchers calculated that the number of deaths per 1 million courses of antibiotics would be about 85 among Zithromax patients versus 32 among amoxicillin patients and 30 among those on no antibiotics. The highest risks were in Zithromax patients with existing heart problems.

Patients in each group started out with comparable risks for heart trouble, the researchers said.

The results suggest there would be 47 extra heart-related deaths per 1 million courses of treatment with Zithromax, compared with amoxicillin. A usual treatment course for Zithromax is about five days, versus about 10 days for amoxicillin and other antibiotics. Zithromax is at least twice as expensive as generic amoxicillin; online prescription drug sellers charge a few dollars per pill for Zithromax.

"People need to recognize that the overall risk is low," said Dr. Harlan Krumholz, a Yale University health outcomes specialist who was not involved in the study. More research is needed to confirm the findings, but still, he said patients with heart disease "should probably be steered away" from Zithromax for now.

The study appears in Thursday's New England Journal of Medicine. The National Heart, Lung and Blood Institute helped pay for the research.

Zithromax, marketed by Pfizer Inc., has been available in the United States for two decades. It's often used to treat bronchitis, sinus infections and pneumonia. Wayne Ray, a Vanderbilt professor of medicine, decided to study the drug's risks because of evidence linking it with potential heart rhythm problems. Also, antibiotics in the same class as Zithromax have been linked with sudden cardiac death.

Zithromax is among top-selling antibiotics. U.S. sales last year totaled $464 million, according to IMS Health, a health care information and services company.

Pfizer issued a statement saying it would thoroughly review the study. "Patient safety is of the utmost importance to Pfizer and we continuously monitor the safety and efficacy of our products to ensure that the benefits and risks are accurately described," the company said.

Patients studied were age 50 on average and not hospitalized. Most had common ailments, including sinus infections and bronchitis. Those on Zithromax were about as healthy as those on other antibiotics, making it unlikely that an underlying condition might explain the increased death risk.

Medicaid patients generally have more disability and lower incomes than other patients, so whether the same results would be found in the general population is uncertain, Ray said.

Dr. Bruce Psaty, a professor of medicine at the University of Washington, said doctors and patients need to know about the potential risks. He said the results also raise concerns about long-term use of Zithromax, which other research suggests could benefit people with severe lung disease. Additional research is needed to determine if that kind of use could be dangerous, he said.

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AP Medical Writer Lindsey tanner can be reached at http://www.twitter.com/LindseyTanner

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Men's Breast Cancer Often More Deadly, Study Suggests

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HIV-positive man fights charge that saliva was deadly

Reuters – 6 hrs ago ALBANY, New York (Reuters) - A gay-rights group is urging New York state's high court to overturn the conviction of an HIV-positive man whose saliva was found to be a "dangerous instrument" in a biting case.

David Plunkett was sentenced in 2007 to 10 years in prison for aggravated assault, a felony that requires the use of a "dangerous instrument."

Plunkett argued unsuccessfully the charge could not be sustained because HIV cannot be transmitted through saliva. The Court of Appeals, New York's top court, will hear Plunkett's case on Thursday.

Lambda Legal, a national group that advocates for gays and lesbians and people with HIV, argued in a court brief filed this week that upholding Plunkett's conviction would further stigmatize people living with HIV and AIDS.

"Clearly, the trial court here erroneously believed that HIV could be transmitted by saliva," the Lambda Legal brief reads.

In 2006, the staff at a medical clinic in Ilion, about 70 miles east of Syracuse, called police to complain that Plunkett was causing a disturbance. Police said he punched and bit one of the responding officers, according to court documents.

Herkimer County Court Judge Patrick Kirk in 2007 denied Plunkett's motion to dismiss the aggravated assault charge, ruling that while Plunkett's teeth could not be considered a dangerous instrument, his saliva could.

Plunkett pleaded guilty and was given a 10-year prison sentence. In 2010, an appeals court found that by pleading guilty, Plunkett had forfeited his right to challenge any trial court error.

Plunkett and Lambda Legal argue that under New York law, only substances that are "readily capable of causing death or other serious physical injury" can be considered dangerous instruments.

A number of studies have found saliva does not contain sufficient concentrations of HIV to transmit the virus to other people. According to the Centers for Disease Control and Prevention, "contact with saliva alone has never been shown to result in transmission of HIV."

Plunkett's attorney, Audrey Baron Dunning, argued in an appellate brief that upholding Plunkett's conviction could "open the door for enhanced prosecution of persons with many forms of illness, contagious disease or condition."

The Herkimer County District Attorney's office did not return a call seeking comment.

(Editing by Todd Eastham)

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Most Americans back gun lobby, right to use deadly force

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Looking for a Rush, Kids Play the Deadly Choking Game

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Study: Tax deadline day can be deadly on US roads

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