Azithromycin acts by binding to the 50s ribosomal subunit of susceptible microorganisms and thus interfering with microbial protein synthesis.
Azithromycin is indicated for the treatment
Lower respiratory tract infections: community acquired pneumonia, acute bacterial exacerbations of chronic obstructive pulmonary disease, acute bronchitis due to H. influenza, M.catarrhalis or S. pneumoniae.
Upper respiratory tract infections: ear, nose and throat infections like tonsillitis, sinusitis, otitis media and pharyngitis.
Genitourinary tract infections, including sexual transmitted diseases, urethritis, prostatis, cervicitis, cervicovaginitis and salpingitis due to N.gonorrhoeae and C. trachomatis, Chlamyadial conjunctivitisSkin and soft tissue infections: folliculitis, furuncles, carbuncles, impetigo, pyoderma, infected ulcer, infected dermatitis, cellulitis and erysipelas due to S. aureus, S.pyogenes or S. agalactiae
Dosage and administration
Azithromycin tablets may be taken without regard to food. However, increased tolerability has been observed when tablets are taken with food.
Mild to moderate lower respiratory tract infections, upper respiratory tract infections and uncomplicated skin and soft tissue infections. Adult above 16 years of age: 500 mg as a single dose on the first day followed by 250 mg once daily on day 2 through 5 for a total dose of 1.5g or 500 mg once daily for 3 days
Children below 16 years of age: the usual dose for children is 10mg/kg body weight orally, once a day for 3 days. Alternatively after a 10mg/kg body weight oral loading dose on the first day; therapy can be continued at a dose of 5 mg/kg weight on subsequent four days.Genital ulcer disease due to Haemophilusducreyi
Urethritis and cervicitis due to Neisseria gonorrhoeae: adult above 16 years of age: single 2g dose of Azithromycin.
Azithromycin is well tolerated with a low incidence of side effects in both adults and children. The majority of side effects in both adults and children. The majority of side effects were gastrointestinal in origin, with diarrhea, abdominal discomfort, nausea, vomiting and flatulence. Occasionally reversible elevations in liver transaminase have been seen. Allergic reactions like skin rash may occur. Rarely but potentially serious side effects were angioedema and cholestatic jaundice
Because azithromycin is principally eliminated via the liver, caution should be exercised when azithromycin is administered to patients with impaired hepatic function. There are no data regarding azithromycin usage in patients with renal impairment; thus, caution should be exercised when prescribing azithromycin in these patients.