AZITHROMYCIN

Macrolide antibacterial with fewer gastrointestinal side-effects than erythromycin

Dosage Forms

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Tablet

250 mg
500 mg

Oral suspension

200 mg/5ml in 15mls

Powder for solution for infusion

Azithromycin (as Azithromycin dihydrate) 500 mg

Uses

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  • Gonococcal eye infection
  • Trachoma
  • Bacterial tonsillitis and bronchitis (second line to amoxicillin, e.g. in penicillin-allergic patients)
  • Uncomplicated genital chlamydial infections
  • Non-gonococcal urethritis
  • Upper respiratory tract infection
  • Otitis media
  • Skin and soft-tissue infection
  • Lyme disease

Dose and Duration

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Prevention of secondary case of invasive group A streptococcal infection in patients who are allergic to penicillin

By Mouth

Child 6 months–11 years:12mg/kg once daily (max. per dose 500mg) for 5 days
Child 12–17 years:500mg once daily for 5 days
Adult:500mg once daily for 5 days
Trachoma and gonococcal eye infection (in combination with doxycycline and tetracycline eye ointment)
Adult > 45kg:1 g single dose
Adult <45 kg and child >6months:20 mg/kg single dose
Respiratory-tract infections, otitis media,skin and soft tissue infections

By Mouth

Child 6 months–17 years: 10mg/kg once daily (max. per dose 500mg) for 3 days
Child 6 months–17 years(body- weight 15–25 kg): 200mg once daily for 3 days
Child 6 months–17 years(body- weight 26–35 kg): 300mg once daily for 3 days
Child 6 months–17 years(body- weight 36–45 kg): 400mg once daily for 3 days
Child 6 months–17 years(body- weight 46 kg and above): 500mg once daily for 3 days
Adult:500mg once daily for 3 days, alternatively initially 500mg once daily for 1 day,then 250mg once daily for 4 days
Uncomplicated genital chlamydial infections and non gonococcal urethritis

By Mouth

Child 12 -17 years: 1 g single dose Adult: 1 g single dose
Uncomplicated gonorrhoea[anogenital and pharyngeal infection]

By Mouth

Adult: 2 g single dose
Lyme disease [erythema migrans and/or non-focal symptoms]

By Mouth

Adult: 500mg daily for 17 days
Mild to moderate typhoid due to multiple-antibacterial resistant organisms

By Mouth

Adult: 500mg daily for 7 days
Community-acquired pneumonia, low to moderate severity

By Mouth

Adult:500mg once daily for 3 days, alternatively initially 500mg once daily for 1 day,then 250mg once daily for 4 days
Community-acquired pneumonia, high severity

INITIALLY BY INTRAVENOUS INFUSION

Adult:Initially 500mg once daily for 2 days, then (by mouth)500 mg once daily for a total duration of 7–10 days
Antibacterial prophylaxis for insertion of intra-uterine device

BY MOUTH

Adult:1g for 1 dose

Contraindications

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  • Allergy to azithromycin or erythromycin
  • Liver disease
  • Kidney disease

Side Effects

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Common or very common

  • With oral use - Arthralgia
  • Stomach upset, tooth and tongue discoloration, taste disturbances

Uncommon

  • Dizziness, drowsiness, headache, weakness, paraesthesia
  • Leucopoenia

Interactions

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  • Artemether/lumefantrine (increased risk of irregular heartbeat )

Patient Instructions

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  • Tablets should be taken at least 1 hour before or 2 hours after food
  • Oral suspension can be taken with food
  • Give at least 2 hours apart from magnesium trisilicate compound

Pregnancy

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  • Can be used

Breastfeeding

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  • Can be used

⚠️ Caution

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  • Avoid use in severe liver disease
  • Use with caution in renal failure with eGFR less than 10 ml/minute/1.73 m²