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One of the most popular antibiotics in the U.S., Zithromax is prescribed to about 40 million people per year. FDA approved the Pfizer-manufactured drug in 1991, and since then, the medication has been preferred, as it clears up infections in fewer days than others.

Generically known as azithromycin and also sold under names Zmax and Z-Pak, this antibiotic gets prescribed for conditions ranging from respiratory and skin infections to sexually transmitted diseases. Doctors also give it to children to treat pneumonia and tonsillitis.

Yet, studies have determined multiple side effects associated with Zithromax usage, including Stevens Johnson Syndrome and potentially fatal cardiovascular issues.

Stevens Johnson Syndrome

According to a 2006 report in the National Center for Biotechnology Information, at least two known cases link Stevens Johnson Syndrome (SJS) with Zithromax usage. In these instances, patients developed a rash and had fever, chills, and discoloration around the eyes, but conditions have been treatable.

SJS, associated with multiple medications, can be a potentially fatal reaction and may occur while or after a patient uses a medication. Also known as Toxic Epidermal Necrolysis, SJS frequently starts with a fever, sore throat, and headache, and progresses to skin legions and blisters. As it worsens, the patient may see skin come off in large portions and could experience internal burning, which could be severe enough to cause internal organ damage. As a result, SJS is frequently treated in hospital burn units.

Patients who survive may later experience blindness, light sensitivity, hair and nail loss, scarring, and respiratory problems as a result.

Cardiovascular Concerns

In March 2013, the FDA put out a warning that Zithromax usage is associated with potentially fatal heart rhythms, especially for individuals at risk for certain cardiovascular conditions, like arrhythmias, heart attack, and Torsades De Pointes. The communication came after a 2012 study published in the New England Journal of Medicine that compared a 10-day antibiotic course with a five-day Zithromax course. During the latter, 47 more cardiac deaths occurred per 1 million patients, which was 2.5 times greater than the amount for the standard antibiotic.

In response, the FDA required Pfizer to revise the drug’s label to warn of QT internal prolongation, or the lengthening of the heart’s electrical cycle, which can increase the patient’s risk of death.