Azithromycin - All you need to know for general practice

 Azithromycin


It belongs to a group of antibiotics called Macrolides. They end up with suffix -thromycin like erythromycin, clarithromycin, etc.

It inhibits protien synthesis.

Acts on both gram positive and gram negative bacteria. Also very helpful in atypical bacteria.

PROPERTIES

Bacteriostatic.

Bacteriocidal if given in higher concentrations.

Also has anti inflammatory properties - good in reccurrent COPDs

Excreted mostly from liver and only 12% from kidney.

So it should be avoided  in impaired liver functions and can be given in impaired kidney functions (No need to alter dosage in impaired renal functions)

INDICATIONS

  1. Upper respiratory tract infections like Pharyngitis/ Laryngitis/ Tonsilitis/ Sinusitis
  2. Good for Atypical Pneumonia
  3. Skin Infections by Staph
  4. Middle ear infections
  5. Vaginitis/Urethritis in pregnancy ( Because Aminoglycosides cannot be used in pregnancy)
  6. STD like Chlamydia/Gonorrhea
  7. Preffered in Enteric Fever.

DOSAGES

Pediatric dose

10mg/kg on Day 1 then followed by 5mg/kg for 4 days

Adult dose

500mg OD for 3 days in URTI and 5 days in LRTI

can be given for 15 days in TB and Enteric fever.

SIDE EFFECTS

  • Increases gut motility - so it causes Diarrhea so can be given with lactobacillus in such patients.
  • Rarely causes Arrythmia - Prolonged QT intervals so can be avoided with patients on Amiodarone.
  • Cholestatic Jaundice.
  • Rashes
  • Ototoxicity

POINTS TO REMEMBER

  • It is not effective when given along with food because it is not absorbed in our gut. So ideally it is told to patients to consume before 1 - 2 hours before food.
  • It is not effective if given along with Antacids like Digene syrup.
  • No need to alter doses in renal impairments.



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