Doctoring Healthy Living

Antibiotics and the heart — Think hard

Screen Shot 2015-01-27 at 5.31.03 AMMy colleague and friend Dr. Melissa Walton-Shirley wrote a nice review article on antibiotics and cardiac issues over at

It is worth a look. MWS is a heck of writer. Although she is writing to doctors, the issues she raises about antibiotics are relevant to everyone.

I recently reviewed a case in which a serious cardiac rhythm problem occurred in a patient given multiple medications, including an antibiotic.

In our current culture of pills-for-everything, even, “pre-diseases,” drug interactions and adverse effects have never been more important.

Neither patients nor doctors can know all these possible interactions, instead it is important to know that drugs do not come free.

Antibiotics, for instance, do more than just kill bad bacteria. They kill gut flora–the good bacteria; they affect the metabolism and absorption of other pills, and some antibiotics can alter electrical activity of the heart–your only heart.

Think hard about taking or prescribing pills. Use your smartphone apps. Enroll the pharmacist as a consultant.



3 replies on “Antibiotics and the heart — Think hard”

My lord. Maybe that explains why my afib resurfaced after 2 years following several rounds of antibiotics (plus some heavy duty anti-inflammatories) after several dental surgeries. Just wondering now . . . . . .

Your latest column on theHeart/Medscape Cardiology is also excellent! Dr. Mandrola, might I be bold enough to suggest that you consider writing a column about the Friberg et al. paper just published in issue 65(3) of JACC? I have noticed a couple of occasions when a study whose results failed to support some “aggressive” approach to medicine were written up one way – semi-honestly – on MedPageToday and another way – grossly dishonestly, making it seem that the aggressive ideology was validated – on Medscape Cardiology. This is a paper that people in your field, or else their patients, really ought to hear about, and as it’s still not been mentioned in the news feed on Medscape, it’s starting to look like someone would prefer that it go down the memory hole.

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