Azithromycin is a broad-spectrum antibiotic belonging to the macrolide class. It is primarily used to treat bacterial infections, including respiratory tract infections, otolaryngological infections, and sexually transmitted diseases. This medication inhibits bacterial protein synthesis, effectively killing or suppressing the growth of pathogens.
Due to its long half-life, azithromycin allows for extended dosing intervals, which can improve patient compliance. Clinically, it is commonly used to treat community-acquired pneumonia, acute otitis media, and uncomplicated urinary tract infections. It can also serve as an alternative antibiotic for patients allergic to penicillin.
The scientific name of this medication is Azithromycin. In Taiwan and Hong Kong, common brand names include:
Other brand names may exist in different regions. Always verify the correct drug name on the medication label before use.
Generic and brand-name drugs contain the same active ingredient, but formulations or dosages may differ. Patients should follow their healthcare provider’s instructions to select the appropriate formulation and should not change the medication type independently.
Azithromycin belongs to the macrolide antibiotic class, which also includes erythromycin and clarithromycin. These antibiotics inhibit bacterial protein synthesis by blocking the 50S ribosomal subunit. Its unique chemical structure allows it to penetrate certain bacteria effectively, acting within bacterial cells.
Unlike β-lactam antibiotics, azithromycin is stable against β-lactamase enzymes, making it suitable for infections caused by resistant strains. It is also classified as a sustained-release antibiotic, maintaining a longer duration of action within tissues.
Main indications include:
In certain cases, it may also be used to prevent Pneumocystis jirovecii pneumonia in HIV-infected patients.
This drug is effective against Mycoplasma, Chlamydia, and some Gram-positive bacterial infections. However, it is important to note that it has no efficacy against viral infections such as influenza or common colds, and antibiotics should not be overused.
Common mild side effects include:
These occur in approximately 10-15% of cases and usually resolve spontaneously within a few days after stopping the medication. A small number of patients may experience dry mouth or altered taste.
Serious but rare side effects include:
If symptoms such as chest pain, palpitations, or jaundice occur, discontinue the medication immediately and seek medical attention.
Contraindications include:
Reports have indicated that this medication may induce QT interval prolongation. Cardiac patients should evaluate their risk before use.
Use during pregnancy should be limited to necessary cases. Use in the third trimester may increase the risk of neonatal hearing loss. Breastfeeding women should avoid use, as the drug may be secreted into breast milk. Elderly patients over 65 and those with low body weight require dosage adjustments.
Concurrent use with the following drugs may increase risks:
Concurrent use may increase cardiac toxicity or alter blood drug concentrations. Combining with theophylline may prolong its half-life, requiring blood level monitoring. Alcohol consumption should be avoided during treatment as it may worsen gastrointestinal side effects. Always inform your healthcare provider of all medications being taken before starting azithromycin.
For adults with respiratory infections, the common dosage is 500 mg on the first day, followed by 250 mg daily for 3-5 days. Pediatric doses are calculated based on weight, typically 10 mg/kg/day. It can be taken on an empty stomach, but taking it with food may reduce gastrointestinal discomfort.
Patients with severe liver impairment should reduce the dose: 500 mg on the first day, then 250 mg daily, for no more than 3 days. Intravenous formulations must be administered strictly according to medical instructions regarding infusion speed; rapid infusion may trigger allergic reactions. For severe infections with poor gastrointestinal absorption, intravenous administration may be considered.
If a dose is missed and less than 6 hours have passed, take it as soon as possible and adjust the next dose accordingly. If close to the next scheduled dose, skip the missed dose and resume normal dosing; do not take a double dose at once. When using divided doses, strictly follow the prescribed schedule.
If multiple doses are missed resulting in treatment interruption, contact your healthcare provider immediately for reassessment. Do not increase the dose on your own due to missed doses, as this may lead to drug accumulation or increased side effects.
Acute overdose may cause severe gastrointestinal symptoms, arrhythmias, or neurological abnormalities. Seek immediate medical attention for gastric lavage or activated charcoal administration. Severe poisoning cases require hospitalization with ECG monitoring and blood drug level assessments.
Symptoms such as fainting, blurred vision, or seizures should be treated as medical emergencies. Healthcare providers may administer antiarrhythmic drugs or electrolyte therapy, with close monitoring of cardiac function.
If I experience stomach discomfort or nausea while taking azithromycin, how can I alleviate these symptoms?
Azithromycin may cause gastrointestinal discomfort. It is recommended to take the medication after meals to reduce irritation. If symptoms persist or are severe, try crushing the tablets and mixing with a small amount of food, or follow your doctor’s instructions to adjust the dosage. Severe vomiting or diarrhea requires discontinuation and consultation with your physician.
Does taking azithromycin with proton pump inhibitors (such as omeprazole) affect its efficacy?
Yes, proton pump inhibitors (like omeprazole) may reduce the absorption of azithromycin, decreasing its effectiveness. If combined use is necessary, your doctor may suggest adjusting the timing of administration or choosing other medications that do not interfere with antibiotic absorption. Always inform your healthcare provider of all medications you are taking.
Do I need to restrict diet or specific nutrients while taking azithromycin?
Generally, no special dietary restrictions are required. However, avoid taking the medication on an empty stomach to minimize gastrointestinal irritation. A high-fiber diet can help alleviate constipation caused by the medication, and foods containing probiotics (like yogurt) may improve gut flora balance. Caffeine or alcohol-containing drinks may worsen nausea and should be consumed in moderation.
Can I extend the duration of treatment on my own if symptoms do not fully resolve after completing the course?
Absolutely not. Do not extend the treatment without your healthcare provider’s approval. Prolonging the course may lead to antibiotic resistance or increased side effects. If symptoms persist, return to your doctor for evaluation, which may include sputum culture or other tests to determine whether a change in antibiotics or additional treatments are necessary.
What precautions should patients with a history of arrhythmias take when using azithromycin?
Azithromycin can prolong the QT interval on the electrocardiogram. Patients with arrhythmias should have an ECG assessment before use. When combined with antiarrhythmic drugs such as quinidine, close monitoring is essential. If symptoms such as palpitations, dizziness, or difficulty breathing occur during treatment, discontinue the medication immediately and seek medical attention.
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