Azithromycin drug card

Need quick access to key Azithromycin information? This drug card provides concise details on dosage, administration, contraindications, and common side effects. We focus on practical application, offering clear guidelines for safe and effective use.

Dosage: Typical adult doses range from 500mg on day one, followed by 250mg daily for four days. However, always consult the prescribing information for specific patient needs and potential adjustments based on the indication (e.g., community-acquired pneumonia, chlamydia). Pediatric dosing varies significantly with weight and the infection being treated; precise calculations are paramount.

Administration: Azithromycin is usually administered orally, ideally with food to minimize gastrointestinal upset. Intravenous formulations exist for specific situations, but require careful monitoring by healthcare professionals. Ensure proper hydration to support drug metabolism and excretion.

Contraindications: Known hypersensitivity to azithromycin or other macrolides is a strict contraindication. Patients with a history of QT prolongation should also avoid this medication due to potential cardiac risks. Careful consideration is required for patients with hepatic or renal impairment. Always check for drug interactions before prescribing.

Side Effects: The most commonly reported side effects include nausea, vomiting, diarrhea, and abdominal pain. Less frequent, but potentially serious, adverse reactions include abnormal liver function tests and cardiac arrhythmias. Prompt medical attention is necessary for any concerning symptoms.

Azithromycin Drug Card

Administer Azithromycin orally, once daily, with food. The standard adult dose for common infections is 500mg on day one, followed by 250mg daily for four days. Always follow your doctor’s precise instructions regarding dosage and duration.

Common Uses

Azithromycin treats various bacterial infections, including those affecting the respiratory tract (like pneumonia and bronchitis), skin (cellulitis), and sexually transmitted infections (like chlamydia). It’s also effective against ear infections in children.

Precautions and Side Effects

Caution is advised if you have liver or kidney problems. Common side effects include nausea, diarrhea, and abdominal pain. Rare but serious side effects include allergic reactions (anaphylaxis) and heart rhythm problems (QT prolongation). Report any concerning symptoms immediately to your physician. Do not take Azithromycin if you are allergic to it or other macrolide antibiotics.

Drug Interactions

Azithromycin can interact with certain medications, especially those affecting heart rhythm or metabolized by the liver. Discuss all medications, including over-the-counter drugs and supplements, with your doctor before starting Azithromycin.

Missed Dose

Take the missed dose as soon as you remember, unless it’s almost time for your next dose. Do not double the dose.

Storage

Store Azithromycin at room temperature, away from moisture and light.

Mechanism of Action

Azithromycin inhibits bacterial protein synthesis. It achieves this by binding to the 50S ribosomal subunit of susceptible bacteria. This binding prevents the translocation step of protein synthesis, effectively halting bacterial growth and leading to bacterial cell death.

Specifically, azithromycin binds to the 23S rRNA within the 50S subunit. This interaction interferes with the peptidyl transferase activity of the ribosome. Reduced peptidyl transferase activity directly impacts the ability of bacteria to synthesize proteins needed for survival and reproduction.

The drug’s broad-spectrum activity stems from its ability to target a wide range of bacterial species. However, resistance mechanisms, like mutations in the 23S rRNA gene, can reduce azithromycin’s efficacy.

Note: This mechanism of action applies to susceptible bacteria only. Azithromycin’s effectiveness varies based on bacterial species and resistance patterns.

Clinical Significance: Understanding this mechanism is key to appropriate antibiotic selection and managing potential resistance development. Prescribing azithromycin should always consider current susceptibility patterns within a specific clinical context.

Indications and Uses

Azithromycin treats a variety of bacterial infections. It effectively combats infections of the respiratory tract, including bronchitis and pneumonia. It’s also a common treatment for ear infections (otitis media) in children and adults.

Skin infections, like cellulitis and erysipelas, also respond well to azithromycin. Additionally, it targets certain sexually transmitted infections, such as chlamydia and gonorrhea.

Azithromycin is frequently prescribed for the treatment of pelvic inflammatory disease (PID) in women. It’s also used in the treatment of certain eye infections.

Remember, azithromycin is only effective against bacterial infections; it does not work against viral infections such as the common cold or influenza. Always consult your doctor to determine the appropriate antibiotic for your specific condition.

Dosage and Administration

Azithromycin dosage depends heavily on the infection being treated and the patient’s characteristics. Always follow your doctor’s prescription exactly. Do not adjust the dosage or duration without consulting your physician.

Adult Dosage

Typical regimens involve a single dose or a course of several days. For instance, a common treatment for uncomplicated chlamydia involves a single 1 gram oral dose. Other infections might require a 500 mg daily dose for three days, or a 250 mg daily dose for five days. Your doctor will determine the appropriate regimen for your specific needs.

Pediatric Dosage

Pediatric dosages are calculated based on weight. A common dosage is 10 mg/kg on the first day, followed by 5 mg/kg daily for four days. Precise instructions will be provided by your child’s physician, taking into account their weight and the infection.

Administration

Azithromycin is usually administered orally, as tablets or suspension. Take it with a full glass of water. You can take it with or without food, although some individuals might experience stomach upset on an empty stomach. Follow your doctor’s instructions carefully regarding the timing of doses.

Important Considerations

Factor	Recommendation
Liver Disease	Reduced dosage may be necessary.
Kidney Disease	Dosage adjustment might be needed; consult your doctor.
Pregnancy/Breastfeeding	Discuss with your doctor before taking Azithromycin.

Missed Dose

If you miss a dose, take it as soon as you remember, unless it’s almost time for your next dose. Do not double the dose to catch up. Contact your doctor if you have concerns about missed doses.

Contraindications and Precautions

Avoid azithromycin if you have a known allergy to azithromycin, erythromycin, or any other macrolide antibiotic. This includes a history of allergic reactions like severe skin rashes (e.g., Stevens-Johnson syndrome, toxic epidermal necrolysis).

Liver Function

Azithromycin can affect your liver. If you have pre-existing liver problems, your doctor will carefully monitor your liver function during treatment. Report any signs of liver damage, such as jaundice (yellowing of the skin or eyes), dark urine, or unusual fatigue, immediately.

QT Prolongation

Azithromycin may prolong the QT interval on an electrocardiogram (ECG), increasing the risk of potentially fatal heart rhythm problems. This risk is heightened in patients with known QT prolongation, low potassium levels (hypokalemia), or those taking other medications that prolong the QT interval. Your physician should carefully consider this before prescribing azithromycin.

Myasthenia Gravis

• Azithromycin can worsen symptoms of myasthenia gravis, a neuromuscular disease. Discuss this with your doctor if you have this condition.

Other Precautions:

1. Inform your doctor about all medications you are currently taking, including over-the-counter drugs and herbal supplements. Some medications may interact negatively with azithromycin.
2. Azithromycin may increase the risk of Clostridium difficile-associated diarrhea. Report any persistent diarrhea immediately.
3. Use caution when driving or operating machinery, as azithromycin can cause dizziness or drowsiness in some individuals.
4. During pregnancy or breastfeeding, discuss the use of azithromycin with your doctor to weigh the benefits against potential risks to the infant.

Renal Impairment

Adjustments in dosage may be needed for patients with severely impaired kidney function. Your doctor will determine the appropriate dose based on your kidney function.

Adverse Effects and Monitoring

Monitor patients closely for common side effects.

• Gastrointestinal Issues: Nausea, vomiting, and diarrhea are frequent. Encourage patients to report these promptly and consider alternatives if severe.
• Cardiac Effects: Prolonged QT interval is a possibility, particularly with high doses or pre-existing cardiac conditions. Obtain an EKG before initiating treatment in high-risk individuals and monitor for arrhythmias.
• Hepatic Effects: While rare, liver inflammation can occur. Regular liver function tests are recommended, especially for prolonged therapy.
• Hypersensitivity Reactions: Allergic reactions, ranging from mild rash to severe anaphylaxis, are possible. Patients should be instructed to stop taking the medication and seek immediate medical attention if such reactions occur.
• Neurological Effects: Dizziness, headache, and vertigo are reported. Advise patients to avoid driving or operating machinery if these symptoms develop.

Specific monitoring strategies include:

1. Baseline and periodic liver function tests (LFTs).
2. Baseline and periodic electrocardiograms (EKGs), especially in high-risk patients.
3. Regular assessment of gastrointestinal symptoms.
4. Close observation for signs of hypersensitivity reactions.
5. Careful monitoring for any neurological symptoms.

Patient education is paramount. Clearly explain potential side effects and emphasize the importance of reporting any unusual symptoms to their healthcare provider.

Drug Interactions

Azithromycin’s interaction profile warrants careful consideration. Avoid concurrent use with ergot alkaloids (e.g., ergotamine, dihydroergotamine) due to the risk of ergotism, characterized by peripheral vasoconstriction. This combination can lead to severe complications.

Interactions Affecting Metabolism

Azithromycin is a substrate of cytochrome P450 3A4 (CYP3A4). Co-administration with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) increases azithromycin levels, potentially leading to increased risk of adverse effects like QT prolongation. Conversely, strong inducers (e.g., rifampin, St. John’s wort) may reduce azithromycin effectiveness.

Other Significant Interactions

Concomitant use with digoxin may elevate digoxin serum levels, necessitating careful monitoring. Simultaneous administration with anticoagulants (e.g., warfarin) can increase the risk of bleeding, requiring closer INR monitoring. Always inform your doctor or pharmacist about all medications, including over-the-counter drugs and herbal supplements, before starting azithromycin therapy.

Overdose and Management

Azithromycin overdose is characterized by primarily gastrointestinal symptoms: nausea, vomiting, and diarrhea. Rarely, more serious cardiac effects like QT prolongation can occur.

Immediate Actions

If an azithromycin overdose is suspected, immediately contact a poison control center or seek medical attention. Do not induce vomiting without professional guidance. Supportive care is the mainstay of treatment. This focuses on managing symptoms like dehydration through intravenous fluids and electrolyte correction if necessary.

Monitoring and Treatment

Close monitoring of vital signs, including heart rhythm (ECG), is crucial. Activated charcoal may be considered within a few hours of ingestion, though its efficacy in azithromycin overdose is debated. Specific antidotes are not available. Treatment is largely symptomatic and supportive, focusing on maintaining hydration and cardiovascular stability. Prolonged QT interval requires close observation and potential treatment depending on the severity.