Generally, you should avoid taking that type of antibiotic when on rythmol, as zythromax (and other similar antibiotics) can prolong the QT interval of the heart (a period measured on an EKG that shows how long it takes the heart to electrically "reset" after a beat). If the QT interval is prolonged too much, it can lead to a dangerous heart rhythm. As long as the QT interval is being monitored with EKGs while taking this antibiotic, it is OK to take if the interval does not significantly lengthen. If another class of antibiotic can be used to treat the infection that does not prolong the QT interval, than that would be preferred. The class of antibiotics that are used depends on the specific type of infection and the suspected "bug."
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