What infections is Azithromycin used for?

Azithromycin is one of the drugs that has been highly regarded in recent years and has shown high effectiveness. This drug, with its antibiotic effects and unique properties, is used as one of the main options in the treatment of various bacterial infections. This drug has different applications in diseases related to infection and is being produced in different pharmaceutical forms depending on the needs of patients. However, the side effects and precautions of Azithromycin are very wide and if not followed, it can be life-threatening.

Pharmaceutical forms of azithromycin

Azithromycin drug in pharmaceutical forms is lyophilized powder injection for reconstitution 500 mg in a vial, 250 mg and 500 mg tablets, oral suspension 100 mg/5 ml and 200 mg/5 ml.

Uses of azithromycin

Azithromycin is an antibiotic (of the macrolide type), this single-dose form of the drug is used to treat certain infections, including genital infections. This drug works by stopping the growth of bacteria and does not work for viral infections (such as colds and flu). Unnecessary use or incorrect use of any antibiotic can lead to a decrease in its effectiveness. This form of medication is not recommended for use in children.

Uses of azithromycin in adults

1. Community acquired pneumonia
2. Uncomplicated skin or skin structure
3. Pharyngitis or tonsillitis
4. Acute bacterial exacerbation of chronic obstructive pulmonary disease
5. Acute bacterial sinusitis
6. Genital ulcer disease (chancreoid)
7. Non-gonococcal or gonococcal urethritis and cervicitis
8. Pelvic inflammatory disease
9. Pertussis (off label)
10. Endocarditis (off label)
11. Cat scratch disease (off label)

Uses of azithromycin in children

1. Chlamydia trachomatis infection (off label)
2. Cat scratch disease (off label)
3. Acute otitis media
4. Pharyngitis or tonsillitis

Pharmacological effects and mechanism of action of Azithromycin

It binds to the 50S ribosomal subunit of susceptible microorganisms and blocks the dissociation of peptidyl tRNA from ribosomes and stops RNA-dependent protein synthesis. This drug does not affect nucleic acid synthesis. It is concentrated in phagocytes and fibroblasts, as shown by in vitro incubation techniques. Also, in vivo studies show that concentration in phagocytes may contribute to drug distribution in inflamed tissues.

Dosage of Azithromycin

Take this medication by mouth, with or without food. Taking it with food may help reduce stomach upset. Mix contents of one packet in 2 oz (60 ml) of water and drink quickly. Antacids containing aluminum or magnesium may reduce the absorption of azithromycin if taken at the same time. If you are taking an antacid containing aluminum or magnesium, wait at least 2 hours before or after taking azithromycin. If there is no improvement after taking the medicine, stop taking the medicine and see a doctor.

Dosage of azithromycin in adults

1. It is recommended for the treatment of community-acquired pneumonia caused by Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae or Streptococcus pneumoniae in suitable patients for oral treatment. The recommended dose is 500 mg once a day, and it is possible to increase the dose.
2. For the treatment of pharyngitis or tonsillitis caused by Streptococcus pyogenes, it is used as an alternative treatment in people who cannot use first-line treatment. The dosage is 500 mg once a day.
3. This drug is used to treat uncomplicated skin and skin structure infections caused by Staphylococcus aureus, Streptococcus pyogenes or Streptococcus agalactia. The dosage is 500 mg once a day, which can be increased up to 250 mg a day.
4. Azithromycin is recommended for acute bacterial exacerbation of chronic bronchitis caused by Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae. The dosage is 500 mg per day for 3 days or 500 mg once a day.
5. This drug is suitable for the treatment of acute bacterial sinusitis caused by Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae. The recommended dose is 500 mg per day.
6. It is recommended for the treatment of genital ulcers in men caused by Hemophilus dukrai (chancreoid).
7. It is prescribed by doctors to treat urethritis and cervicitis caused by Chlamydia trachomatis or Neisseria gonorrhea. Also, some doctors prescribe this drug for pelvic inflammatory disease caused by Chlamydia trachomatis, Neisseria gonorrhoea, or Mycoplasma hominis in patients who need initial treatment.
8. The recommended dose for the treatment of pertussis (off-label) is 500 mg once daily, then 250 mg once daily for 4 days.

Time to use azithromycin in children

1. It is recommended for the treatment of acute otitis media in patients over 6 months old caused by Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae. The recommended dose for children older than 6 months is 30 mg/kg per day, which can be taken after consulting a doctor.
2. For community-acquired pneumonia in children over 6 months, 10 mg/kg, which can be increased.
3. It is used to treat pharyngitis or tonsillitis in patients over 2 years of age caused by Streptococcus pyogenes as an alternative treatment in people who cannot use first-line treatment. The total amount of consumption for this disease should not be more than 500 mg per day.
4. Note that this drug should only be used to treat infections that are proven or strongly suspected to be caused by susceptible bacteria to reduce the growth of drug-resistant bacteria and maintain the effectiveness of azithromycin.

Precautions

Before taking Azithromycin, if you are allergic to it or other antibiotics (such as erythromycin, clarithromycin, telithromycin), avoid taking the medicine. Before use, inform the doctor of your medical history, such as liver disease, kidney disease, certain muscle disease (myasthenia gravis), heart problems, low levels of potassium or magnesium in the blood, etc. This medicine may make live bacterial vaccines (such as the typhoid vaccine) not work as well. Before getting any immunizations or vaccinations, tell your healthcare professional that you are using this medicine.

1. Abnormal liver function, hepatitis, cholestatic jaundice, liver necrosis, and liver failure have been reported, some of which have resulted in death. Stop treatment immediately if signs and symptoms of hepatitis occur.
2. Infantile hypertrophic pyloric stenosis (IHPS) has been reported. Advise parents and caregivers directly if vomiting or irritability occurs during feeding.
3. Clostridium difficile-associated diarrhea (CDAD) has been observed in some patients and may range in severity from mild diarrhea to fatal colitis.
4. Exacerbation of symptoms of myasthenia gravis and new onset of myasthenic syndrome have been reported.
5. Antibacterial agents used to treat nongonococcal urethritis may mask or delay the symptoms of incubating syphilis. All patients with venereal urethritis or cervicitis should have serological testing for syphilis and appropriate testing for gonorrhea at the time of diagnosis. If infection is confirmed, initiate appropriate antibacterial therapy and follow-up testing for these diseases.

Cardiovascular death risk of azithromycin drug

1. Observational studies have shown an approximately two-fold increase in the potential short-term risk of acute cardiovascular death in adults exposed to azithromycin compared to other antibacterial drugs, including amoxicillin.
2. The potential risk was greatest during the first five days of treatment and did not appear to be limited to patients with pre-existing cardiovascular disease.
3. The data available in these observational studies are insufficient to establish or reject a relationship between acute cardiovascular death and azithromycin use. When prescribing treatment, balance potential risk with therapeutic benefit.

Azithromycin drug hypersensitivity

1. Serious allergic reactions including angioedema, anaphylaxis, and skin reactions including acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson syndrome, and toxic epidermal necrolysis have been reported.
2. Cases of drug reaction with eosinophilia and systemic symptoms (DRESS) have also been reported.
3. In case of allergic reaction, stop the drug and start appropriate treatment. Note that allergic symptoms may reappear after discontinuation of symptomatic treatment.

The risk of drug interactions with azithromycin

1. Simultaneous use of nelfinavir in steady state with an oral dose of azithromycin will lead to an increase in the serum concentration of the drug. Carefully monitor for side effects of azithromycin.
2. Post-marketing reports suggest that concomitant use of azithromycin may potentiate the effects of oral anticoagulants (such as warfarin), although prothrombin time was not affected in a specific drug interaction study with azithromycin and warfarin. Monitor prothrombin time closely when patients are receiving azithromycin and oral anticoagulants concurrently.
3. Drug interactions with digoxin, colchicine or phenytoin have been observed when combining other macrolides. Until more information is available regarding drug interactions when digoxin, colchicine, or phenytoin is used with azithromycin, close monitoring of patients is recommended.

Azithromycin contraindications

1. Hypersensitivity to azithromycin, erythromycin and any macrolide or ketolide
2. History of cholestatic jaundice or liver dysfunction related to previous use of azithromycin

Azithromycin side effects

Stomach discomfort, diarrhea or loose stools, nausea, vomiting or abdominal pain are some of the side effects of Azithromycin. If any of these effects persist or worsen, tell your doctor or pharmacist right away. Some serious side effects of this drug include hearing changes (such as hearing loss, deafness), eye problems (such as droopy eyelids, blurred vision), difficulty speaking or swallowing, muscle weakness, symptoms of liver problems (such as nausea or vomiting that does not stop). , unusual fatigue, severe stomach or abdominal pain, yellow eyes, dark urine) etc.

If any of these things happen to the patient, see a doctor.

1. diarrhea
2. nausea
3. stomach ache
4. loose stools
5. Local inflammation (community acquired pneumonia)
6. pain at the injection site (community-acquired pneumonia)
7. Anorexia
8. Rash and itching
9. Indigestion
10. Flatulence
11. mucositis
12. Headache
13. It should be noted that the side effects of this drug depend on the use of different medicinal forms and the type of your disease. Consult your doctor regarding the side effects and risks of use.

Azithromycin drug interactions

1. Category X interactions (avoid): mizolastine, pazopanib, pimozide, strong QT-prolonging CYP3A4 inhibitors (moderate risk), topotecan, vincristine (liposomal), elastin, cholera vaccine, doxorubicin (common), fexinidazole
2. Increased effects of drugs by azithromycin (systemic): Probucol, QT-prolonging antipsychotics (moderate risk), QT-prolonging class IC antiarrhythmics (moderate risk), cardiac glycosides, seliprolol, chloroquine, clofazimine, colchicine, cyclosporine (systemic). , dabigatran etexilate, demperidone, tacrolimus (systemic and local), talazoparib, tegasrud, teniposide, tolvaptan, topotecan, tormifen
3. Azithromycin (systemic) effects may be increased by drugs: QT-prolonging kinase inhibitors (moderate risk), moderate and strong QT-prolonging CYP3A4 inhibitors (moderate risk), antidepressants

Azithromycin use during pregnancy and breastfeeding

Available data on use in pregnant women have not identified any drug-related risk for major birth defects, miscarriage, or adverse maternal or fetal outcomes. Also, in animal data, decreased survival and delayed growth were observed in the offspring of pregnant mice that received azithromycin from the sixth day of pregnancy until weaning at a dose equivalent to 4 times the daily dose of 500 mg of adult humans based on body surface area. Information on the effects of this drug on milk production is not available.

Azithromycin storage conditions

Azithromycin should be stored at room temperature and away from light and moisture. All chemical and herbal medicines should be kept out of the reach of children and animals. If you intend to throw away medicine, do this process according to hygiene principles.

The last word about the drug azithromycin

In this article from the online pharmacy magazine Positive Green, the drug azithromycin was reviewed. Finally, as an antibiotic drug with its unique mechanism of action and multiple applications, azithromycin plays a very important role in the treatment of bacterial infections. With the ability to control and inhibit the growth and development of bacteria, this medicine helps to improve human health and reduce the risks associated with infections.

Also, this drug has become a popular option in the treatment of various cases with its advantages such as easy consumption and better tolerance by patients. On the other hand, issues related to overdose and drug interactions should not be forgotten.

Site source: Medscape