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Why You Should Not Ask Your Doctor for a Z-Pak

Tim Boyer's picture
Patients are getting the wrong antibiotics, says study

A new study reveals that the most commonly prescribed drug for treating common ailments is the Z-Pak—but shouldn’t be. Here’s why.


Whenever you or your child comes down with an ear ache, a sore throat or a sinus pain, do you ask your doctor to prescribe a Z-Pak because that is what has worked in the past? A new study shows that the Z-Pak is the most abused antibiotic—and, that it may be doing more harm than good toward treating your illness.

Z-Pak gets its name from the antibiotic azithromycin, aka the Zithromax drug, that compared to several other antibiotics is one of the strongest ones you can use to fight a bacterial infection whenever you have a sore throat, ear ache or sinus pain. However, not only can a bacterial infection cause any of these three common ailments, so can a virus―which is unaffected by antibiotics such as a Z-Pak.

But whether or not a patient is being treated with antibiotics for viral-caused diseases is only part of the problem; the other part is that using strong antibiotics before lesser ones, is overkill and may be contributing to antibiotic resistance and the development of “superbugs.”

Here’s why taking too powerful of an antibiotic can be a health risk

The study recently published in JAMA Internal Medicine found that there is substantial overuse of what health authorities refer to as “non-first-line antibiotics” for three of the most common conditions (sore throat, ear ache and sinus infection) that account for more than 40 million antibiotic prescriptions annually.

"Overall, only 52 percent of patients treated with antibiotics for sinus infections, middle ear infections and pharyngitis (sore throat) received the first-line treatments recommended by prescribing guidelines," stated Dr. David Hyun, an infectious disease specialist who co-authored the study.

So what does this mean? In other words, rather than being treated as per Dr. Oz’s recommendation of “…the shortest dose, of the weakest drug,” first, when ill, patients are too often getting the most powerful medication right off the bat, and this is largely in part due to that is what patients are asking of their physicians.

Here’s what Dr. Oz had to say about it on Today

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Video: Prescribing the Wrong Antibiotics? Dr. Oz Weighs in On Troubling New Study

How Patients Should Approach Their Physician

One recommendation for patients is that they avoid putting any pressure on their physician with a request for a prescription of a Z-Pak just to get in and out of the office visit—or even phone call—and be on their way believing that their health is being appropriately cared for. Something many tired parents are likely guilty of when caring for young children.

The better—and safer way—is to take the time to discuss with your physician whether the cause is more likely to be bacterial or viral and what treatment options are advisable at the stage your illness is in. Because as the study found, patients with sore throats, ear infections and sinus infections were getting the wrong antibiotic at least half the time, and often when not in need of an antibiotic. But if an antibiotic is needed, typically a first-line of treatment one like amoxicillin is more appropriate.

For more about the treatment of sore throat, ear ache or sinus pain, here is an informative article on how Zinc may help you fight both viral and bacterial infections.


NBC’s Today “Are you taking the right kind of antibiotic? Half the time we're not, study says

JAMA Internal Medicine “Frequency of First-line Antibiotic Selection Among US Ambulatory Care Visits for Otitis Media, Sinusitis, and Pharyngitis” Published online October 24, 2016; Adam L. Hersh MD, PhD, et al.