So in absolute terms, if you were taking the doses described in the test and were already at risk for CVD, you increased your risk of death by 0.0245%.
“For this study, the underlying population is that of Tennessee Medicaid enrollees who have either a study antibiotic prescription or who have some portion of their Medicaid experience
selected as a nonuser control period.”
“Persons with low incomes are more likely to be Medicaid recipients or uninsured, have poor-quality health care, and seek health care less often; when they do seek health care, it is more likely to be for an emergency.”
“Low SES is an important determinant of access to health care. Persons with low incomes are more likely to be Medicaid recipients or uninsured, have poor-quality health care, and seek health care less often; when they do seek health care, it is more likely to be for an emergency.”
You know that people on Medicaid are exclusively people of the lowest economic status. To obtain Medicaid you basically have to have very little or no income. People enrolled in Medicaid are people with confounding medical risks.
“People on Medicaid are more likely to smoke, and smoking-related diseases are a major driver of Medicaid spending. Comprehensive Medicaid coverage of smoking cessation counseling and medications can help people on Medicaid quit smoking.”
Smokers and obesity were not excluded from the study you cite.
Bottom line: The cohort of this study is on Medicaid, from Tennessee, and not likely to be following a healthy lifestyle. The increased death rate for this group is minimal for users of azithromycin. No mention of obesity or many other confounding factors. The study was done in 2012 and a decade later no one is raising an alarm or suggesting that azithromycin not be prescribed or taken off the market.
A 2023 JAMA study found that: "Receiving azithromycin versus standard care was not significantly associated with death"
These were patients being treated for COVID-19 and only “Unvaccinated Patients With COVID‐19 and Preexisting Cardiovascular Disease” experienced an increase in death rate.
https://www.nejm.org/doi/suppl/10.1056/NEJMoa1003833/suppl_file/nejmoa1003833_appendix.pdf
https://www.ahajournals.org/doi/full/10.1161/JAHA.122.028939
Increase Medicaid coverage of evidence-based treatment to help people quit using tobacco — TU‑16 - Healthy People 2030 | health.gov.
