What's on this Page
Azithromycin Brand Names
Azasite | Zithromax | Zithromax Tri-Pak | Zithromax Z-Pak | Zmax
What is Azithromycin
Azithromycin is a semisynthetic antibiotic belonging to the macrolide subgroup of azalides and is similar in structure to erythromycin.
Azithromycin offers the advantage that it can be dosed once daily and produces less GI intolerance than does erythromycin.
Azithromycin has a wider spectrum of activity than erythromycin against Mycobacterium avium complex (MAC), Haemophilus influenzae, nontuberculous mycobacteria, and Chlamydia trachomatis.
Another apparent advantage over erythromycin is that azithromycin reaches higher intracellular concentrations, thus increasing its efficacy and duration of action.
These advantages are demonstrated in studies that show that single doses of azithromycin are effective for the treatment of acute otitis media and sexually transmitted diseases (STDs) due to chlamydia and gonorrhea.
Azithromycin is better tolerated and offers shorter treatment durations compared with clarithromycin.
Azithromycin is used for the treatment of a variety of respiratory infections, including otitis media, pharyngitis/tonsillitis, pertussis, community-acquired pneumonia, and sinusitis.
However, macrolides are not recommended for empiric monotherapy of acute bacterial sinusitis due to high rates of Streptococcus pneumoniae resistance (approximately 30%).
Azithromycin is also used for the treatment of STDs due to chlamydia and gonorrhea, and for the prophylaxis and treatment of Mycobacterium avium complex (MAC) disease.
An ophthalmic preparation is used for the treatment of bacterial conjunctivitis.
Long-term azithromycin is used off-label to improve lung function and decrease pulmonary exacerbation in cystic fibrosis patients 6 years and older who have sputum cultures persistently positive for P. aeruginosa.
Additionally, long-term azithromycin may be used as an add-on therapy in adults with moderate to severe asthma. Prior to starting therapy, sputum should be checked for atypical mycobacteria.
While azithromycin has been studied in regimens for H. pylori eradication and some studies show efficacy, the azithromycin-containing regimens have not been as effective as regimens containing clarithromycin in terms of eradication rates. Macrolide cross-resistance is also an issue.
Indications
- babesiosis
- Bacillus anthracis
- bacterial conjunctivitis
- Bacteroides bivius
- bartonellosis
- Bordetella pertussis
- Borrelia burgdorferi
- bronchitis
- Campylobacter jejuni
- campylobacteriosis
- CDC coryneform group G
- chancroid
- chlamydia infection
- Chlamydia trachomatis
- chlamydial infection prophylaxis
- Chlamydophila pneumoniae
- cholera
- Clostridium perfringens
- community-acquired pneumonia
- coronavirus disease 2019 (COVID-19)
- cystic fibrosis
- dental abscess (apical)
- dental abscess (periapical)
- dental infection
- dentoalveolar infection
- endocarditis prophylaxis
- Gardnerella vaginalis
- gonorrhea
- gonorrhea prophylaxis
- granuloma inguinale
- Haemophilus ducreyi
- Haemophilus influenzae (beta-lactamase negative)
- Haemophilus influenzae (beta-lactamase positive)
- Helicobacter pylori
- Klebsiella granulomatis
- Legionella pneumophila
- Lyme disease
- lymphogranuloma venereum
- Moraxella catarrhalis
- Mycobacterium avium
- Mycobacterium avium complex (MAC) prophylaxis
- Mycobacterium avium complex infection
- Mycobacterium intracellulare
- Mycoplasma genitalium
- Mycoplasma hominis
- Mycoplasma pneumoniae
- Neisseria gonorrhoeae
- non-gonococcal urethritis (NGU)
- ophthalmia neonatorum
- otitis media
- pelvic inflammatory disease (PID)
- Peptostreptococcus sp.
- pertussis (whooping cough)
- pertussis prophylaxis
- pharyngitis
- pneumonia
- Prevotella bivia
- rheumatic fever prophylaxis
- Rickettsia tsutsugamushi
- Salmonella typhi
- severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection
- shigellosis
- sinusitis
- skin and skin structure infections
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis
- Streptococcus agalactiae (group B streptococci)
- Streptococcus mitis
- Streptococcus pneumoniae
- Streptococcus pyogenes (group A beta-hemolytic streptococci)
- Streptococcus sp.
- Streptococcus sp. (Group C)
- Streptococcus sp. (Group F)
- Streptococcus sp. (Group G)
- syphilis
- tonsillitis
- Toxoplasma gondii
- toxoplasmic encephalitis
- toxoplasmosis
- traveler’s diarrhea
- Treponema pallidum
- typhoid fever
- Ureaplasma urealyticum
- Vibrio cholerae
- Viridans streptococci
Side Effects
- abdominal pain
- acute generalized exanthematous pustulosis (AGEP)
- agitation
- anaphylactic shock
- anaphylactoid reactions
- anemia
- angioedema
- anorexia
- anosmia
- anxiety
- arthralgia
- asthenia
- atopic dermatitis
- azotemia
- blurred vision
- bronchospasm
- candidiasis
- chest pain (unspecified)
- chills
- cholestasis
- conjunctivitis
- constipation
- contact dermatitis
- corneal erosion
- cough
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
- dysgeusia
- dysosmia
- dyspepsia
- dyspnea
- dysuria
- eczema vaccinatum
- edema
- elevated hepatic enzymes
- emotional lability
- eosinophilia
- erythema
- erythema multiforme
- fatigue
- fever
- flatulence
- gastritis
- headache
- hearing loss
- hepatic failure
- hepatic necrosis
- hepatitis
- hyperbilirubinemia
- hyperglycemia
- hyperkalemia
- hyperkinesis
- hypoglycemia
- hypokalemia
- hyponatremia
- hypotension
- injection site reaction
- insomnia
- interstitial nephritis
- irritability
- jaundice
- keratitis
- leukemia
- leukopenia
- lymphocytosis
- lymphoma
- lymphopenia
- maculopapular rash
- malaise
- melena
- myasthenia
- nasal congestion
- nausea
- neutropenia
- ocular discharge
- ocular irritation
- ocular pain
- ocular pruritus
- palpitations
- pancreatitis
- paresthesias
- pharyngitis
- photosensitivity
- pleural effusion
- pruritus
- pseudomembranous colitis
- pyloric stenosis
- QT prolongation
- rash
- renal failure (unspecified)
- rhinitis
- seizures
- sinusitis
- Stevens-Johnson syndrome
- stomatitis
- superinfection
- syncope
- thrombocytopenia
- tinnitus
- tongue discoloration
- torsade de pointes
- toxic epidermal necrolysis
- urticaria
- uveitis
- vaginitis
- ventricular tachycardia
- vertigo
- vesicular rash
- visual impairment
- vomiting
- xerophthalmia
Monitoring Parameters
- ECG
- LFTs
Contraindications
- allogeneic stem cell transplant
- apheresis
- AV block
- bradycardia
- breast-feeding
- cardiomyopathy
- celiac disease
- contact lenses
- diarrhea
- females
- fever
- geriatric
- heart failure
- hepatic disease
- hepatitis
- human immunodeficiency virus (HIV) infection
- hyperparathyroidism
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypothermia
- hypothyroidism
- infants
- jaundice
- leukemia
- long QT syndrome
- lymphoma
- macrolide hypersensitivity
- myasthenia gravis
- myocardial infarction
- neonates
- pheochromocytoma
- pregnancy
- pseudomembranous colitis
- QT prolongation
- renal failure
- renal impairment
- rheumatoid arthritis
- serious hypersensitivity reactions or anaphylaxis
- sexually transmitted disease
- sickle cell disease
- sleep deprivation
- sodium restriction
- stroke
- sunlight (UV) exposure
- systemic lupus erythematosus (SLE)
- viral infection
Interactions
- Aclidinium; Formoterol
- Albuterol
- Albuterol; Ipratropium
- Alfuzosin
- Aluminum Hydroxide
- Aluminum Hydroxide; Magnesium Carbonate
- Aluminum Hydroxide; Magnesium Hydroxide
- Aluminum Hydroxide; Magnesium Hydroxide; Simethicone
- Aluminum Hydroxide; Magnesium Trisilicate
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Anagrelide
- Apomorphine
- Arformoterol
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Asenapine
- Aspirin, ASA; Pravastatin
- Atomoxetine
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Caffeine; Ergotamine
- Calcium Carbonate; Magnesium Hydroxide
- Ceritinib
- Chloroquine
- Chlorpromazine
- Ciprofloxacin
- Cisapride
- Citalopram
- Clofazimine
- Clomipramine
- Clozapine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine
- Colchicine; Probenecid
- Conjugated Estrogens; Bazedoxifene
- Crizotinib
- Cyclosporine
- Dasatinib
- Degarelix
- Desflurane
- Desipramine
- Deutetrabenazine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Dienogest; Estradiol valerate
- Digoxin
- Dihydroergotamine
- Disopyramide
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doxepin
- Dronedarone
- Droperidol
- Drospirenone
- Drospirenone; Estradiol
- Drospirenone; Ethinyl Estradiol
- Drospirenone; Ethinyl Estradiol; Levomefolate
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Eliglustat
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Enflurane
- Entrectinib
- Ergotamine
- Eribulin
- Escitalopram
- Estradiol; Levonorgestrel
- Estradiol; Norethindrone
- Estradiol; Norgestimate
- Ethinyl Estradiol
- Ethinyl Estradiol; Desogestrel
- Ethinyl Estradiol; Ethynodiol Diacetate
- Ethinyl Estradiol; Etonogestrel
- Ethinyl Estradiol; Levonorgestrel
- Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
- Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
- Ethinyl Estradiol; Norelgestromin
- Ethinyl Estradiol; Norethindrone
- Ethinyl Estradiol; Norethindrone Acetate
- Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
- Ethinyl Estradiol; Norethindrone; Ferrous fumarate
- Ethinyl Estradiol; Norgestimate
- Ethinyl Estradiol; Norgestrel
- Ezogabine
- Fingolimod
- Flecainide
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol
- Formoterol; Mometasone
- Foscarnet
- Fosphenytoin
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Glasdegib
- Glycopyrrolate; Formoterol
- Goserelin
- Granisetron
- Halogenated Anesthetics
- Haloperidol
- Halothane
- Histrelin
- Hydroxychloroquine
- Hydroxyzine
- Ibutilide
- Iloperidone
- Imipramine
- Indacaterol
- Indacaterol; Glycopyrrolate
- Inotuzumab Ozogamicin
- Isoflurane
- Itraconazole
- Ivosidenib
- Ketoconazole
- Lapatinib
- Lefamulin
- Lenvatinib
- Leuprolide
- Leuprolide; Norethindrone
- Levalbuterol
- Levofloxacin
- Levonorgestrel
- Lithium
- Lofexidine
- Long-acting beta-agonists
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Macimorelin
- Magnesium Hydroxide
- Maprotiline
- Mefloquine
- Meperidine; Promethazine
- Mestranol; Norethindrone
- Metaproterenol
- Methadone
- Metronidazole
- Midostaurin
- Mifepristone
- Mirtazapine
- Moxifloxacin
- Nelfinavir
- Nilotinib
- Norethindrone
- Norgestrel
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Olodaterol
- Ondansetron
- Oral Contraceptives
- Osimertinib
- Oxaliplatin
- Paliperidone
- Panobinostat
- Pasireotide
- Pazopanib
- Pentamidine
- Perphenazine
- Perphenazine; Amitriptyline
- Phenylephrine; Promethazine
- Phenytoin
- Pimavanserin
- Pimozide
- Pirbuterol
- Pitolisant
- Posaconazole
- Pravastatin
- Primaquine
- Procainamide
- Prochlorperazine
- Promethazine
- Propafenone
- Protriptyline
- Quetiapine
- Quinidine
- Quinine
- Ranolazine
- Ribociclib
- Ribociclib; Letrozole
- Rilpivirine
- Risperidone
- Romidepsin
- Salmeterol
- Saquinavir
- Segesterone Acetate; Ethinyl Estradiol
- Sertraline
- Sevoflurane
- Short-acting beta-agonists
- Siponimod
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Solifenacin
- Sorafenib
- Sotalol
- Sunitinib
- Tacrolimus
- Talazoparib
- Tamoxifen
- Telavancin
- Telithromycin
- Terbutaline
- Tetrabenazine
- Thioridazine
- Tiotropium; Olodaterol
- Tolterodine
- Toremifene
- Trazodone
- Tricyclic antidepressants
- Trifluoperazine
- Trimipramine
- Triptorelin
- Umeclidinium; Vilanterol
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Voriconazole
- Vorinostat
- Warfarin
- Ziprasidone