Azithromycin

Indications
Oral
Skin and soft tissue infections
Adult: 500 mg once daily for 3 days. Alternatively, 500 mg as a single dose on the 1st day followed by 250 mg once daily for 4 days.
Child: >6 mth: 10 mg/kg; 15-25 kg: 200 mg; 26-35 kg: 300 mg; 36-45 kg: 400 mg. Doses to be taken once daily for 3 days.
Oral
Respiratory tract infections
Adult: 500 mg once daily for 3 days. Alternatively, 500 mg as a single dose on the 1st day followed by 250 mg once daily for 4 days.
Child: >6 mth: 10 mg/kg; 15-25 kg: 200 mg; 26-35 kg: 300 mg; 36-45 kg: 400 mg. Doses to be taken once daily for 3 days.
Oral
Uncomplicated genital infections due to Chlamydia trachomatis
Adult: 1 g as a single dose.
Oral
Uncomplicated gonorrhoea
Adult: 2 g as a single dose.
Oral
Prophylaxisof disseminated Mycobacterium avium complex (MAC) infections
Adult: 1.2 g once every wk. For treatment or secondary prophylaxis: 500 mg once daily with other antimycobacterials.
Child: >6 mth: 10 mg/kg once daily for 3 days.
Oral
Granuloma inguinale
Adult: Initially, 1 g followed by 500 mg daily. Alternatively, 1 g once a wk for at least 3 wk, until all lesions have completely healed.
Intravenous
Active immunisation against typhoid fever caused by Salmonella typhi
Adult: 500 mg once daily for 7 days.
Contraindications
Hypersensitivity.
Warnings / Precautions
Impaired liver and renal function; pregnancy and lactation; children.
Adverse Reactions
Mild to moderate nausea, vomiting, abdominal pain, dyspepsia, flatulence, diarrhoea, cramping; angioedema, cholestatic jaundice; dizziness, headache, vertigo, somnolence; transient elevations of liver enzyme values.
Drug Interactions
Antacids containing aluminium and magnesium salts reduce rate of absorption. Increased risk of ergot toxicity.
Potentially Fatal: Increased serum concentrations of digoxin and ciclosporin.
See Below for More azithromycin Drug Interactions
Food Interactions
Food may alter absorption.
Mechanism of Actions
Azithromycin blocks transpeptidation by binding to 50s ribosomal subunit of susceptible organisms and disrupting RNA-dependent protein synthesis at the chain elongation step.
Absorption: Reduced by food (capsule formulation); peak plasma concentrations after 2-3 hr.
Distribution: Extensive into the tissues (concentrations higher than those in blood), WBC (high concentrations), CSF (small amounts).
Metabolism: Liver (demethylation).
Excretion: Via the bile (as unchanged drug and metabolites); via the urine (6% of the dose). Elimination half-life: about 68 hr.
Administration
Tab & susp: May be taken with or without food. (May be taken w/ meals to reduce GI discomfort.)
Cap & extended release microspheres: Should be taken on an empty stomach. (Take on an empty stomach 1 hr before or 2 hr after meals.)
Storage Conditions
Intravenous: Store below 30°C. Oral: Store below 30°C.
ATC Classification
J01FA10 - azithromycin ; Belongs to the class of macrolides. Used in the systemic treatment of infections.
S01AA26 - azithromycin ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
Storage
Intravenous: Store below 30°C. Oral: Store below 30°C.
Available As
  • Azithromycin 1 gm
  • Azithromycin 1% w/v
  • Azithromycin 10 mg
  • Azithromycin 100 mg
  • Azithromycin 1000 mg
  • Azithromycin 125 mg
  • Azithromycin 2%
  • Azithromycin 2% w/w
  • Azithromycin 20 mg
  • Azithromycin 200 mg
  • Azithromycin 250 mg
  • Azithromycin 40 mg
  • Azithromycin 50 mg
  • Azithromycin 500 mg
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