Indications
Azithromycin is indicated for infections caused by susceptible organisms, in upper respiratory tract infections including sinusitis, pharyngitis and tonsillitis, in lower respiratory tract infections including bronchitis and pneumonia, skin and soft tissue infections, and otitis media. Azithromycin is indicated for pelvic inflammatory disease. Azithromycin is indicated in the treatment of uncomplicated genital infections due to Chlamydia trachomatis.
Therapeutic Class
Macrolides
Pharmacology
Azithromycin binds to the 23S rRNA of the 50S ribosomal subunit. It blocks protein synthesis by inhibiting the transpeptidation/ translocation step of protein synthesis and by inhibiting the assembly of the 50S ribosomal subunit.
Dosage
Intravenous-
Community-acquired pneumonia:
Adult: 500 mg as single IV daily dose for at least 2 days followed by a single oral daily dose of 500 mg to complete 7-10 days of therapy.
Elderly: No dosage adjustment needed.
Pelvic inflammatory disease:
Adult: 500 mg as single IV daily dose for 1-2 days followed by a single oral daily dose of 250 mg tablet to complete a 7-day therapy.
Elderly: No dosage adjustment needed.
Oral-
Skin and soft tissue infections, Respiratory tract infections:
Adult: 500 mg once daily for 3 days. Alternatively, 500 mg as a single dose on the 1st day followed by 250 mg once daily for 4 days.
Child: >6 mth 10 mg/kg; 15-25 kg: 200 mg; 26-35 kg: 300 mg; 36-45 kg: 400 mg. All doses to be taken once daily for 3 days.
Elderly: No dosage adjustment needed.
Uncomplicated genital infections due to Chlamydia trachomatis, Chancroid, Non-gonococcal cervicitis/urethritis due to Chlamydia trachomatis:
Adult: 1 g as a single dose.
Elderly: No dosage adjustment needed.
Prophylaxis of disseminated Mycobacterium avium complex (MAC) infections:
Adult: 1.2 g once wkly. For treatment or secondary prophylaxis: 500 mg once daily w/ other antimycobacterials.
Child: 20 mg/kg once wkly. Max: 1.2 g. Alternatively 5 mg/kg once daily. Max: 250 mg.
Elderly: No dosage adjustment needed.
Uncomplicated gonorrhoea:
Adult: 2 g as a single dose.
Elderly: No dosage adjustment needed.
Active immunisation against typhoid fever caused by Salmonella typhi:
Adult: 1 g once daily for 5 days or 500 mg once daily for 7 days.
Child: 3-17 yr 20 mg/kg (Max: 1 g) once daily for 5-7 days or 10 mg/kg (Max: 500 mg).
Elderly: No dosage adjustment needed.
Granuloma inguinale:
Adult: Initially, 1 g followed by 500 mg daily. Alternatively, 1 g once a wk for at least 3 wk, until all lesions have completely healed.
Elderly: No dosage adjustment needed.
Ophthalmic-
Bacterial conjunctivitis:
Adult: Instill 1 drop in the affected eye(s) bid for 2 days, then once daily for the next 5 days.
Administration
Oral: As common with many other antibiotics, Azithromycin should be taken at least 1 hour before or 2 hours after meal and antacid.
Interaction
Azithromycin absorption was reduced in presence of food and antacid. So, Azithromycin should be administered 1 hour before or 2 hours after taking food or antacid. In patients receiving ergot alkaloids Azithromycin should be avoided concurrently because of the possibility of ergotism resulting from interaction of Azithromycin with the cytochrome P-450 system. However, no cases of such interaction have been reported. Macrolides have been known to increase the plasma concentration of Digoxin and Cyclosporin. Therefore, if co-administration is necessary, caution should be exercised and serum level of Digoxin and Cyclosporin should be checked. There have been no pharmacokinetic drug interactions between Azithromycin and Warfarin, Theophylline, Carbamazepine, Methylprednisolone and Cimetidine.
Contraindications
Azithromycin is contraindicated in patients hypersensitive to Azithromycin or any other macrolide antibiotic. Co-administration of ergot derivatives and Azithromycin is contraindicated. Azithromycin is contraindicated in patients with hepatic diseases.
Side Effects
Azithromycin is well tolerated with a low incidence of side effects. Majority of the side effects were mild to moderate in nature and of gastro-intestinal in origin with nausea, abdominal discomfort, vomiting, flatulence and diarrhea. Allergic reactions such as rash have been occurred and there have also been rare reports of serious hypersensitivity reactions. Reversible elevations in liver transaminases have been seen with a frequency similar to the comparative macrolides and penicillins used in clinical trials. Transient mild reductions in neutrophil counts have occasionally been observed in clinical trials, although a causal relationship to Azithromycin has not been established.
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Rozith 500mg 1pcs
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