Azithromycin is a broad-spectrum antibiotic belonging to the macrolide class of antibiotics. It is primarily used to treat infections caused by bacteria, including respiratory infections, ear, nose, and throat infections, and sexually transmitted diseases. This medication inhibits bacterial protein synthesis, effectively killing or suppressing the growth of pathogens.
Due to its long half-life, azithromycin can be taken at longer intervals, increasing patient adherence to the medication regimen. Clinically, it is often used to treat community-acquired pneumonia, acute otitis media, and uncomplicated urinary tract infections. This drug can also be used as an alternative antibiotic for patients allergic to penicillin.
The generic name of this medication is azithromycin. In Taiwan and Hong Kong, common brand names include:
Generic drugs and brand-name drugs contain the same active ingredient, but the dosage form or strength may differ. Patients should follow the instructions of their physician or pharmacist to choose the appropriate dosage form and should not change the drug specifications on their own.
Azithromycin belongs to the macrolide class of antibiotics, which includes erythromycin and clarithromycin. This class of antibiotics works by blocking the 50S subunit of the bacterial ribosome, inhibiting protein synthesis. Its unique chemical structure allows it to penetrate certain bacteria effectively, acting on intracellular bacteria.
Unlike β-lactam antibiotics, azithromycin is stable against β-lactamase, making it suitable for infections caused by specific resistant strains. This medication is also classified as a sustained-release antibiotic, maintaining a longer duration of action in tissues.
The main indications include:
This drug is effective against infections caused by mycoplasma, chlamydia, and certain Gram-positive bacteria. However, it is important to note that it has no effect on viral infections such as influenza or the common cold, and antibiotics should not be misused.
Common mild side effects include:
Severe but rare side effects include:
Contraindications include:
It should only be used during pregnancy when necessary, as use in the third trimester may increase the risk of hearing loss in newborns. Breastfeeding women should avoid use, as the drug may be secreted in breast milk. Elderly patients over 65 years and those who are underweight may require dosage adjustments.
Combining with the following medications may increase risks:
Taking with theophylline may prolong the half-life of the latter, and blood levels should be monitored. Alcohol should be avoided during the treatment period, as it may exacerbate gastrointestinal discomfort. Patients should inform their physician of all medications they are currently taking before using any prescription or over-the-counter drugs.
The common dosage for adults with respiratory infections is 500 mg on the first day, followed by 250 mg daily for a total treatment duration of 3-5 days. Pediatric dosing is calculated based on weight, typically 10 mg/kg/day. It can be taken on an empty stomach, but taking it with food may reduce gastrointestinal discomfort.
Patients with severe liver dysfunction need a dose reduction, starting with 500 mg on the first day followed by 250 mg daily, with a treatment duration not exceeding 3 days. Intravenous administration should strictly follow medical advice regarding the rate of infusion, as rapid injection may trigger allergic reactions. Intravenous administration may be considered for patients with severe infections and poor gastrointestinal absorption.
If a dose is missed and it is less than 6 hours late, it should be taken as soon as possible, and the next dose time should be adjusted. If it is close to the next scheduled dose, the missed dose should be skipped, and normal dosing should resume; do not take a double dose. When using a multi-dose regimen, the schedule provided by the physician should be strictly followed.
If multiple doses are missed and the treatment course is interrupted, the healthcare provider should be contacted immediately to reassess the medication plan. Do not increase the single dose on your own due to missed doses, as this may lead to drug accumulation or exacerbated side effects.
Acute overdose may lead to severe gastrointestinal symptoms, arrhythmias, or neurological abnormalities. Medical attention should be sought immediately, and gastric lavage or activated charcoal adsorption may be performed. Severe cases of poisoning may require hospitalization for monitoring of electrocardiogram and blood drug levels.
If symptoms such as fainting, blurred vision, or seizures occur, they should be considered a medical emergency. Healthcare professionals may use antiarrhythmic medications or electrolyte therapy, and close monitoring of cardiac function indicators is necessary.
Taking azithromycin may cause gastrointestinal discomfort; it is recommended to take the medication after meals to reduce irritation. If symptoms persist or are severe, you may try crushing the tablet and mixing it with a small amount of food, or adjust the dosage as directed by your physician. Severe vomiting or diarrhea requires immediate cessation of the medication and contacting a physician.
Will taking azithromycin with acid suppressants (e.g., omeprazole) affect its efficacy?Yes, proton pump inhibitors (e.g., omeprazole) may reduce the absorption of azithromycin, leading to decreased efficacy. If co-administration is necessary, the physician may recommend adjusting the timing of the doses or choosing other antacids that do not interfere with the absorption of the antibiotic. Always inform your physician of all medications you are currently taking before use.
Do I need to restrict my diet or specific nutrient intake while taking azithromycin?Generally, there is no need for special dietary restrictions, but it is advisable to avoid taking it on an empty stomach to reduce gastrointestinal irritation. A high-fiber diet may help alleviate constipation caused by the medication, and foods containing probiotics (like yogurt) may improve gut microbiota imbalance. Caffeinated or alcoholic beverages may exacerbate nausea, so consumption should be moderate.
If my symptoms do not completely resolve after finishing the azithromycin course, can I extend the medication duration on my own?Absolutely not! Extending the treatment without a physician's consent may lead to antibiotic resistance or exacerbation of side effects. If symptoms persist, you should return for a check-up; the physician may conduct sputum cultures or other tests to determine if a change in antibiotic or additional treatment is necessary.
What precautions should individuals with a history of arrhythmia take when using azithromycin?Azithromycin may affect the QT interval on the electrocardiogram, and patients with arrhythmia should undergo an electrocardiogram assessment before use. Close monitoring is required when co-administering antiarrhythmic medications (e.g., quinidine). If symptoms such as palpitations, dizziness, or difficulty breathing occur during treatment, the medication should be stopped immediately, and medical evaluation should be sought.
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