AZITHROMYCIN (a-zi-thro-mye'sin) AzaSite, Zithromax, Zmax Classifications: antibiotic; macrolide antibiotic; Therapeutic: antibiotic Prototype: Erythromycin Pregnancy Category: B |
500 mg, 600 mg tablets; 100 mg/5 mL, 200 mg/5 mL, 1 g/packet oral suspension; 500 mg injection; 1% ophthalmic; Zmax extended release: 176 mg/5 mL oral suspension
A macrolide antibiotic that reversibly binds to the 50S ribosomal subunit of susceptible organisms and consequently inhibits protein synthesis.
Effective for treatment of mild to moderate infections caused by pyogenic organisms.
Pneumonia, lower respiratory tract infections, pharyngitis/tonsillitis, gonorrhea, nongonococcal urethritis, skin and skin structure infections due to susceptible organisms, otitis media, Mycobacterium aviumintracellulare complex infections, acute bacterial sinusitis. Zmax: acute bacterial sinusitis and community acquired pneumonia. AzaSite: bacterial conjunctivitis.
Bronchitis, Helicobacter pylori gastritis.
Hypersensitivity to azithromycin, erythromycin, or any of the macrolide antibiotics; viral infections.
Older adults or debilitated persons, hepatic or renal impairment; GI disease; ventricular arrhythmias, QT prolongation; UV exposure; pregnancy (category B), and lactation.
Bacterial Infections Adult: PO 500 mg on day 1, then 250 mg q24h for 4 more d IV 500 mg q.d. for at least 2 d, administer 1 mg/mL over 3 h or 2 mg/mL over 1 h Child (≥6 mo): PO 10 mg/kg on day 1, then 5 mg/kg for 4 more d (max: 250 mg/d) Acute Bacterial Sinusitis Adult: PO 500 mg once daily x 3 d. Zmax: single one-time dose of 2 g. Child ( ≥6 mo): PO 10 mg/kg once daily x 3 d Otitis Media Child (>6 mo): PO 30 mg/kg as a single dose or 10 mg/kg once daily (not to exceed 500 mg/d) for 3 d or 10 mg/kg as a single dose on day 1 followed by 5 mg/kg/d on days 25 Gonorrhea Adult: PO 2 g as a single dose Chancroid Adult: PO 1 g as a single dose Child: PO 20 mg/kg as single dose (max: 1 g) Bacterial Conjunctivitis Adult: Ophthalmic 1 drop b.i.d x 2 d then daily x 5d Renal Impairment Clcr <10 mL/min: use with caution |
Intravenous PREPARE: Intermittent: Reconstitute 500-mg vial with 4.8 mL of sterile water for injection and shake until dissolved. Final concentration is 100 mg/mL. Solution must be further diluted to 1.0 or 2.0 mg/mL by adding 5 mL of the 100-mg/mL solution to 500 mL or 250 mL, respectively, of D5W, D5/NS, 0.45NaCl, or other compatible solution. ADMINISTER: Intermittent: Administer 1 mg/mL over 3 h. Infuse 2 mg/mL over 1 h. Note: Do not give a bolus dose. INCOMPATIBILITIES Y-site: Amikacin, aztreonam, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, ciprofloxacin, clindamycin, famotidine, fentanyl, furosemide, gentamicin, imipenem/cilastatin, ketorolac, levofloxacin, morphine, ondansetron, piperacillin/tazobactam, potassium, ticarcillin/clavulanate, tobramycin. |
Liver function tests: reversible, asymptomatic elevations in liver enzymes (AST, ALT, gamma glutamyl transferase, alkaline phosphatase) have been reported in some patients treated with azithromycin.
Assessment & Drug Effects
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