Azithromycin

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

  1. babesiosis
  2. Bacillus anthracis
  3. bacterial conjunctivitis
  4. Bacteroides bivius
  5. bartonellosis
  6. Bordetella pertussis
  7. Borrelia burgdorferi
  8. bronchitis
  9. Campylobacter jejuni
  10. campylobacteriosis
  11. CDC coryneform group G
  12. chancroid
  13. chlamydia infection
  14. Chlamydia trachomatis
  15. chlamydial infection prophylaxis
  16. Chlamydophila pneumoniae
  17. cholera
  18. Clostridium perfringens
  19. community-acquired pneumonia
  20. coronavirus disease 2019 (COVID-19)
  21. cystic fibrosis
  22. dental abscess (apical)
  23. dental abscess (periapical)
  24. dental infection
  25. dentoalveolar infection
  26. endocarditis prophylaxis
  27. Gardnerella vaginalis
  28. gonorrhea
  29. gonorrhea prophylaxis
  30. granuloma inguinale
  31. Haemophilus ducreyi
  32. Haemophilus influenzae (beta-lactamase negative)
  33. Haemophilus influenzae (beta-lactamase positive)
  34. Helicobacter pylori
  35. Klebsiella granulomatis
  36. Legionella pneumophila
  37. Lyme disease
  38. lymphogranuloma venereum
  39. Moraxella catarrhalis
  40. Mycobacterium avium
  41. Mycobacterium avium complex (MAC) prophylaxis
  42. Mycobacterium avium complex infection
  43. Mycobacterium intracellulare
  44. Mycoplasma genitalium
  45. Mycoplasma hominis
  46. Mycoplasma pneumoniae
  47. Neisseria gonorrhoeae
  48. non-gonococcal urethritis (NGU)
  49. ophthalmia neonatorum
  50. otitis media
  51. pelvic inflammatory disease (PID)
  52. Peptostreptococcus sp.
  53. pertussis (whooping cough)
  54. pertussis prophylaxis
  55. pharyngitis
  56. pneumonia
  57. Prevotella bivia
  58. rheumatic fever prophylaxis
  59. Rickettsia tsutsugamushi
  60. Salmonella typhi
  61. severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection
  62. shigellosis
  63. sinusitis
  64. skin and skin structure infections
  65. Staphylococcus aureus (MSSA)
  66. Staphylococcus epidermidis
  67. Streptococcus agalactiae (group B streptococci)
  68. Streptococcus mitis
  69. Streptococcus pneumoniae
  70. Streptococcus pyogenes (group A beta-hemolytic streptococci)
  71. Streptococcus sp.
  72. Streptococcus sp. (Group C)
  73. Streptococcus sp. (Group F)
  74. Streptococcus sp. (Group G)
  75. syphilis
  76. tonsillitis
  77. Toxoplasma gondii
  78. toxoplasmic encephalitis
  79. toxoplasmosis
  80. traveler’s diarrhea
  81. Treponema pallidum
  82. typhoid fever
  83. Ureaplasma urealyticum
  84. Vibrio cholerae
  85. Viridans streptococci

Side Effects

  1. abdominal pain
  2. acute generalized exanthematous pustulosis (AGEP)
  3. agitation
  4. anaphylactic shock
  5. anaphylactoid reactions
  6. anemia
  7. angioedema
  8. anorexia
  9. anosmia
  10. anxiety
  11. arthralgia
  12. asthenia
  13. atopic dermatitis
  14. azotemia
  15. blurred vision
  16. bronchospasm
  17. candidiasis
  18. chest pain (unspecified)
  19. chills
  20. cholestasis
  21. conjunctivitis
  22. constipation
  23. contact dermatitis
  24. corneal erosion
  25. cough
  26. diaphoresis
  27. diarrhea
  28. dizziness
  29. drowsiness
  30. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)
  31. dysgeusia
  32. dysosmia
  33. dyspepsia
  34. dyspnea
  35. dysuria
  36. eczema vaccinatum
  37. edema
  38. elevated hepatic enzymes
  39. emotional lability
  40. eosinophilia
  41. erythema
  42. erythema multiforme
  43. fatigue
  44. fever
  45. flatulence
  46. gastritis
  47. headache
  48. hearing loss
  49. hepatic failure
  50. hepatic necrosis
  51. hepatitis
  52. hyperbilirubinemia
  53. hyperglycemia
  54. hyperkalemia
  55. hyperkinesis
  56. hypoglycemia
  57. hypokalemia
  58. hyponatremia
  59. hypotension
  60. injection site reaction
  61. insomnia
  62. interstitial nephritis
  63. irritability
  64. jaundice
  65. keratitis
  66. leukemia
  67. leukopenia
  68. lymphocytosis
  69. lymphoma
  70. lymphopenia
  71. maculopapular rash
  72. malaise
  73. melena
  74. myasthenia
  75. nasal congestion
  76. nausea
  77. neutropenia
  78. ocular discharge
  79. ocular irritation
  80. ocular pain
  81. ocular pruritus
  82. palpitations
  83. pancreatitis
  84. paresthesias
  85. pharyngitis
  86. photosensitivity
  87. pleural effusion
  88. pruritus
  89. pseudomembranous colitis
  90. pyloric stenosis
  91. QT prolongation
  92. rash
  93. renal failure (unspecified)
  94. rhinitis
  95. seizures
  96. sinusitis
  97. Stevens-Johnson syndrome
  98. stomatitis
  99. superinfection
  100. syncope
  101. thrombocytopenia
  102. tinnitus
  103. tongue discoloration
  104. torsade de pointes
  105. toxic epidermal necrolysis
  106. urticaria
  107. uveitis
  108. vaginitis
  109. ventricular tachycardia
  110. vertigo
  111. vesicular rash
  112. visual impairment
  113. vomiting
  114. 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
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856
Scroll to Top