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Zithromax (Azithromycin)

DosageQuantityPriceCheck product
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What is Azithromycin

Azithromycin is a bacteriostatic (and for some species bactericidal) agent belonging to the azalides, a subclass of macrolides. Azithromycin prevents RNA-dependent protein synthesis by binding to the 50S ribosomal subunit.

Azithromycin Drug Recommendation

Basic: in infections with Gram-positive coccus, penicillins are nonetheless the primary alternative, so long as no resistance or β-lactamase inhibition happens. Macrolides solely come into consideration if penicillin resistance or hypersensitivity exists and moreover for pathogens for which penicillins are ineffective, however macrolides are (e.g. Legionella pneumophila, for which it is likely one of the first brokers of alternative). One of many benefits of Azithromycin over erythromycin is its extra beneficial pharmacokinetic profile, which signifies that it solely must be used as soon as a day. As well as, the brief therapy period of Azithromycin (3 or 5 days, and for some indications at the same time as a single therapy) is a bonus in comparison with erythromycin and the opposite macrolides; furthermore, using Azithromycin is cheaper.

Acute rhinosinusitis nearly all the time heals itself. Painkillers (paracetamol), steaming and the nasal administration of a saline resolution or a decongestant can relieve the signs. Antibiotics should not often obligatory. Antibiotics needs to be given if a bacterial an infection is suspected and if the affected person is significantly in poor health, and antibiotics needs to be thought of if the affected person’s resistance is impaired and if the fever persists or recurs for greater than 5 days. For the selection of antibiotics, when indicated, see the acute rhinosinusitis therapy plan.

In acute pharyngotonsillitis, ache reduction with paracetamol is the primary alternative. Antibiotics are not often indicated. In extreme pharyngotonsillitis, with immune deficiency or on the recommendation of the GGD, a narrow-spectrum penicillin equivalent to pheneticillin or phenoxymethylpenicillin might be chosen. In case of penicillin hypersensitivity, Azithromycin for 3 days is first alternative. All macrolides are equally efficient in opposition to streptococci, however Azithromycin is most well-liked due to its brief period of use and price. If there’s a peritonsillar infiltrate or if therapy with narrow-spectrum penicillins has inadequate impact, amoxicillin/clavulanic acid is chosen.

Within the therapy of otitis media acuta, a wait-and-see coverage with enough ache reduction is most well-liked. If the impact on ache and/or fever is inadequate after three days, antimicrobial therapy with amoxicillin needs to be began. In high-risk teams (see otitis media acuta therapy plan) and with extreme generalised signs, antimicrobial therapy needs to be began instantly.

What Should You Discuss To Your Doctor Before Using This Medicine

  • Being pregnant
    • Azithromycin crosses the placenta (in animals).
    • Teratogenesis: Affordable expertise (with a number of doses) from retrospective research exhibits no improve within the threat of start defects. A latest examine exhibits barely elevated threat of spontaneous miscarriage.
    • Suggestion: Can be utilized if any of the popular medicine (e.g. penicillins, cephalosporins) can’t be used.

  • Lactation
    • Transition in breast milk: Sure, to a (very) small extent.
    • Pharmacological impact: Regardless of the lengthy half-life, clinically related ranges are unlikely to be constructed up within the toddler. No severe uncomfortable side effects have been noticed in infants. In principle, it’s doable that the toddler intestinal flora is affected. This will likely result in diarrhoea and doable colonisation with yeasts or moulds.

Contraindications: sensitivity to macrolides.

Azithromycin Drug Interactions

Cautious when combining with medicinal merchandise that extend the QT interval equivalent to class IA and III antiarrhythmic brokers

  • flecainide
  • antipsychotics
  • antidepressants
  • antipsychotics
  • clarithromycin
  • erythromycin
  • fluoroquinolones
  • imidazole
  • triazole antimycotics
  • ketoconazole
  • pentamidine
  • sure antimalarial brokers
  • non-sedating antihistamines
  • levomepromazine
  • methadone
  • 5HT₃-antagonists
  • prucalopride
  • vandetanib

Azithromycin probably will increase publicity to Pgp substrates equivalent to digoxin and colchicine. Throughout therapy with Azithromycin and after discontinuation, scientific follow-up and probably monitoring of digoxin ranges are obligatory. Azithromycin will increase the publicity to ciclosporin; if co-administered, test the ciclosporin degree and modify the dose if obligatory.

Antacids scale back the height serum focus of Azithromycin by roughly 24%; take Azithromycin no less than 1 hour earlier than or 2 hours after antacids. Nevertheless, the general bioavailability doesn’t change. Probably Azithromycin enhances the impact of vitamin Okay antagonists.

The poisonous restrict of ergotamine and derivatives has been reached earlier with using some macrolides (resulting in ergotism); keep away from the mix Azithromycin and ergotamine.

Azithromycin Dosage

In youngsters, use the suspension; this may be dosed per 0.5 ml (e.g. in a baby weighing approx. 14 kg, dosage for 3 days: 3.5 ml 1×/day).

  1. Therapy of infections
    • Adults and kids > 45 kg: 500 mg 1×/day for 3 days or 500 mg 1×/day on the primary day adopted by 250 mg 1×/day on days 2-5.
    • Kids ≤ 45 kg: Suspension: 10 mg/kg physique weight 1×/day for 3 days or 10 mg/kg physique weight 1×/day on the primary day, adopted by 5 mg/kg physique weight 1×/day on days 2 to five. Few knowledge can be found on the use in youngsters < 1 12 months of age.

  2. Streptococcal pharyngitis in youngsters
    • Kids: Suspension: 10-20 mg/kg physique weight 1×/day, for 3 days; most 500 mg/day. Few knowledge can be found on the use in youngsters < 1 12 months of age.

  3. Group-acquired pneumonia (CAP)
    • Adults: 500 mg 1×/day. Remedy period: 3 days.

  4. Sexually transmitted ailments brought on by Chlamydia trachomatis
    • Adults: 1 g in a single donation.

  5. Offlabel: Gonorrhoea
    • Adults: 2 g in a single present (4 tablets of 500 mg), and solely in case of absolute contraindication to ceftriaxone and the absence of a resistance sample of the pressure.

  6. Lyme illness prophylaxis after a tick chew
    • Adults (particularly pregnant ladies) and kids ≥ 8 years previous:  If a tick has been on the pores and skin for greater than 24 hours and was eliminated lower than 72 hours in the past, a single dose of antibiotics or watchful ready might be chosen. If not contraindicated, doxycycline is given to non-pregnant individuals ≥ 8 years of age.
      • Posology of Azithromycin: adults 500 mg as soon as, youngsters 10 mg/kg physique weight (max. 500 mg) as soon as inside 72 hours after tick elimination.
    • Kids < 8 years previous: If a tick has been on the pores and skin for greater than 24 hours and was eliminated lower than 72 hours in the past, a single dose of antibiotics or watchful ready might be chosen.
      • Dosage of Azithromycin: as soon as 10 mg/kg physique weight, inside 72 hours of tick elimination.

  7. Erythema migrans
    • Adults and kids ≥ 8 years: In case of contraindications to doxycycline and hypersensitivity to amoxicillin, Azithromycin might be given.
      • Posology of Azithromycin: adults 500 mg 1×/day, youngsters 10 mg/kg physique weight (max. 500 mg) 1×/day.
      • Remedy period: 5 days.
    • Kids < 8 years previous: In case of contraindications to doxycycline and hypersensitivity to amoxicillin, Azithromycin might be given.
      • Posology of Azithromycin: 10 mg/kg physique weight (max. 500 mg) 1×/day.
      • Remedy period: 5 days.

  8. MAC an infection prophylaxis in HIV-infected sufferers
    • Adults: 1200 mg 1×/week.

Severely impaired renal operate: publicity to Azithromycin might improve by roughly 33%; modify dose if obligatory.

Administration: The suspension and tablets could also be taken with meals. Shake the suspension earlier than use. A bitter aftertaste might be prevented by ingesting fruit juice instantly after taking the suspension.

Azithromycin Indications

Infections brought on by micro-organisms delicate to Azithromycin:

  • of the higher respiratory tract (sinusitis, pharyngitis, tonsillitis) and acute otitis media
  • of the decrease respiratory tract (acute bronchitis, gentle to reasonable pneumonia acquired outdoors the hospital
  • of pores and skin and mushy tissues equivalent to:
    • cellulite
    • ecthyma ulcer
    • erysipelas, erysipeloid
    • erythrasma
    • folliculitis
    • furunkel
    • impetigo, impetigo of different dermatoses
    • erythema migrans and the Borrelia lymphoma
    • wound an infection excluding contaminated burns.
  • uncomplicated Chlamydia trachomatis an infection of urethra and cervix;
  • Lyme illness prophylaxis after a tick chew
  • prophylaxis in opposition to Mycobacterium avium intracellulare complicated (MAC) an infection, in HIV-infected sufferers at a complicated stage (CD4 depend ≤ 100/mm³).

Azithromycin shouldn’t be appropriate to be used in extreme infections requiring speedy excessive blood concentrations, equivalent to extreme pneumonia.

Azithromycin Precautions

QT prolongation: use warning in instances of established or elevated threat of QT prolongation equivalent to clinically related bradycardia (< 50 min),

  • hypokalaemia
  • hypocalcaemia
  • hypomagnesaemia
  • cardiac arrhythmia
  • extreme coronary heart failure
  • co-medication with medicinal merchandise that extend the QT interval
  • congenital
  • acquired QT prolongation

Particular care needs to be taken within the aged, as proarrhythmic circumstances might happen in them. In case of extreme renal impairment (creatinine clearance < 10 ml/min), elevated publicity (33%) happens.

Hepatic ailments: hepatitis, cholestatic icterus, hepatic necrosis and hepatic failure have been reported, deadly in some instances; discontinue use instantly if indicators of hepatitis happen. With current liver illness, a quickly creating asthenia related to icterus, darkish urine, bleeding tendency or hepatic encephalopathy might happen. Use Azithromycin with warning in current important liver illness and test liver operate assessments instantly if indicators and signs of liver dysfunction happen.

Cross-resistance: cross-resistance exists between macrolides and with lincomycins.

Azithromycin shouldn’t be indicated for the therapy of contaminated burns. When diarrhoea is extreme and chronic, take into account diagnosing antibiotic-associated or pseudomembranous colitis. Extreme allergic reactions, as with different macrolides, have been reported in uncommon instances; if these happen, discontinue use.

Hypertrophic pylorus stenosis has been reported in neonates (as much as 42 days); inform dad and mom and carers to contact the physician in case of persistent vomiting and irritation throughout feeding.

Azithromycin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur:

  • nausea
  • stomach ache
  • flatulence
  • diarrhoea
  • vomiting
  • dyspepsia
  • anorexia
  • Pores and skin rash, itching
  • Joint ache
  • Fatigue
  • Dizziness, headache, paraesthesia, style dysfunction
  • Visible disturbance
  • Deafness
  • Decreased lymphocyte depend, elevated eosinophil depen
  • Decreased bicarbonate of blood

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. 


Information concerning psychotic disorders, included within the review of Azithromycin, is used for the informative features exclusively as well as should not be thought-about to alternative to licensed healthcare or referral of the well being treatment distributor.


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Frequently asked questions

  • What is Azithromycin Generic?

    Azithromycin Generic is used to treat certain bacterial infections in many different parts of the body. This medicine may mask or delay the symptoms of syphilis. It is not effective against syphilis infections.

  • What to do if you miss a dose?

    If you miss a dose of Azithromycin Generic, take it as quickly as potential. However, whether it is virtually time to your subsequent dose, skip the missed dose and return to your common dosing schedule. Do not double doses.

  • What if u take too much Azithromycin Generic?

    If an overdose happens, name your physician or call your nearest hospital. You might have pressing medical care. You might also contact the poison management at your local hospital.

  • How to store Azithromycin Generic?

    Store at room temperature between 59-77 F (15-25 C) away from light and moisture, kids and pets. 

  • What Should I Avoid While Taking Azithromycin Generic?

    Marked drowsiness may occur avoid alcoholic drinks alcohol, sedatives, and tranquillizers may increase drowsiness excitability may occur, especially in children be careful when driving a motor vehicle or operating machinery 

  • What are the side effects of Azithromycin Generic?

    Among side effects may be diarrhoea or loose stools, nausea, abdominal pain, vomiting, uneven heartbeats and loss of appetite.

  • What are the Contraindication?

    Hypersensitivity to Generic Azithromycin Generic and related drugs such as Azithromycin Generic or erythromycin.

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Last Updated on November 8, 2021 by Toni El Clikos

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