500 mg PO once, then 250 mg once daily for 4 days 2 g extended release suspension PO once 500 mg IV as single dose for at least 2 days; follow with oral therapy with single dose of 500 mg to complete 7-10 days course of therapy Infection of pharynx, cervix, urethra, or rectum: Ceftriaxone 250 mg IM once plus azithromycin 1 g PO once (preferred) or alternatively doxycycline 100 mg PO q12hr for 7 days CDC STD guidelines: MMWR Recomm Rep. June 5, 20(RR3);1-137 Agitation Allergic reaction Anemia Anorexia Candidiasis Chest pain Conjunctivitis Constipation Dermatitis (fungal) Dizziness Eczema Edema Enteritis Facial edema Fatigue Gastritis Headache Hyperkinesia Hypotension Increased cough Insomnia Leukopenia Malaise Melena Mucositis Nervousness Oral candidiasis Pain Palpitations Pharyngitis Pleural effusion Pruritus Pseudomembranous colitis Rash Rhinitis Seizures Somnolence Urticaria Vertigo Anaphylaxis Angioedema Anorexia Bronchospasm Constipation Dermatologic reactions Dyspepsia Elevated liver enzymes Erythema multiforme Flatulence Oral candidiasis Pancreatitis Pseudomembranous colitis Pyloric stenosis, rare reports of tongue discoloration Stevens-Johnson syndrome Torsades de pointes Toxic epidermal necrolysis Vomiting/diarrhea, rarely resulting in dehydration Neutropenia Elevated bilirubin, AST, ALT, BUN, creatinine Alterations in potassium Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Use with caution in abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and hepatic failure have been reported, some of which have resulted in death; discontinue azithromycin immediately if signs and symptoms of hepatitis occur Injection-site reactions can occur with IV route In treatment of gonorrhea or syphilis, perform susceptibility culture tests before initiating azithromycin therapy; may mask or delay symptoms of incubating gonorrhea or syphilis. Bacterial or fungal superinfection may result from prolonged use Prolonged QT interval: Cases of torsades de pointes have been reported during postmarketing surveillance; use with caution in patients with known QT prolongation, history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias, or uncompensated heart failure; also use with caution if coadministering with drugs that prolong QT interval or proarrhythmic conditions (eg, hypokalemia, hypomagnesemia); elderly patients may be more susceptible to drug-associated effects on QT interval Pneumonia: PO azithromycin is safe and effective only for community-acquired pneumonia (CAP) due to C pneumoniae, H influenzae, M pneumoniae, or S pneumoniae Cases of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) reported; despite successful symptomatic treatment of allergic symptoms, when symptomatic therapy was discontinued, allergic symptoms recurred soon thereafter in some patients without further azithromycin exposure; if allergic reaction occurs, the drug should be discontinued and appropriate therapy instituted; physicians should be aware that allergic symptoms may reappear when symptomatic therapy discontinued Endocarditis prophylaxis: Indicated only for high-risk patients, per current AHA guidelines Use caution in renal impairment (Cr Cl Because of the low levels of azithromycin in breastmilk and use in infants in higher doses, it would not be expected to cause adverse effects in breastfed infants (Lact Med; https://nih.gov/newtoxnet/lactmed.htm) Binds to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl t RNA from ribosomes, causing RNA-dependent protein synthesis to arrest; does not affect nucleic acid synthesis Concentrates in phagocytes and fibroblasts, as demonstrated by in vitro incubation techniques; in vivo studies suggest that concentration in phagocytes may contribute to drug distribution to inflamed tissues Y-site: Amikacin, aztreonam, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, ciprofloxacin, clindamycin, droperidol, famotidine, fentanyl, furosemide, gentamicin, imipenem, cilastatin, ketorolac, levofloxacin, morphine, piperacillin-tazobactam, ondansetron(? ), potassium chloride, ticarcillin-clavulanate, tobramycin The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Azithromycin is one of the most commonly prescribed antibiotics on the market. Millions of doses have been administered to patients dealing with bacterial infections such as bronchitis and pneumonia, as well as infections of the ears, lungs, and other organs. In the past couple of years, the drug has come under some scrutiny. The Food and Drug Administration announced in 2013 that azithromycin can cause a potentially fatal disturbance in a person’s heart rhythm. These two points are very important to remember: In patients with heart disease, though, azithromycin and other macrolide antibiotics – such as clarithromycin, erythromycin, and telithromycin – can speed up the heart so that it beats very fast, up to 200 times per minute. When the heart is beating that fast, its pumping action is greatly diminished – it can’t take in blood and pump it out correctly. As a result, blood pressure drops and a loss of consciousness becomes a risk. If a person experiences these symptoms while driving, a crash could easily happen. Worse still, if the condition isn’t treated, the heart could stop pumping altogether. Without rapid treatment – for example, applying an electrical impulse with a defibrillator – the patient could die.
Jan 6, 2009. Generic Name Azithromycin multiple manufacturers Common Brand Name Zithromax Pfizer U. S. Popularity 11th most commonly. Jul 20, 2017. Zithromax azithromycin is most familiar to the public as the "Z-Pak," a convenient five-day pill regimen used to treat bacterial infections.