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Azythromycin is the common antibiotic taken for upper respiratory and other infections. Commonly referred to as a Z Pak, this antibiotic can be wonderfully effective, but it may come with a frightening risk that should be considered by doctors and their patients. A recent study of 348,000 Medicaid patients who received Z Paks between 1992 and 2006 revealed a threefold higher risk of death from heart attacks when compared to patients treated with amoxicillin, another commonly used antibiotic. This study should make doctors rethink prescribing Z Paks for patients when equally effective alternatives are available without the apparent risk of heart attacks, particularly for patients with heart disease. Moreover, the manufacturer should have warned doctors and their patients of this risk when making millions of dollars selling this antibiotic. It is the obligation of the pharmaceutical company to properly test and study drugs and to put them on the market with adequate warnings, particularly when a safer and effective alternative is already available to the public and the medical field.