Adult Dosing
Community-acquired pneumonia (mild severity), Pharyngitis/tonsillitis (second line therapy), Skin/skin structure (uncomplicated)
- 500 mg PO as a single dose on day 1, then 250 mg PO qd x 4 days
Acute bacterial exacerbations of chronic obstructive pulmonary disease (mild to moderate)
- 500 mg PO x 3 days
- Alternate: 500 mg PO as a single dose on day 1, then 250 mg PO qd x 4 days
Acute bacterial sinusitis
Genital ulcer disease (chancroid), Non-gonoccocal urethritis and cervicitis
Gonococcal urethritis and cervicitis
Prevention of Disseminated MAC Infections
- 1200 mg PO qwk, can be given with rifabutin
Treatment of Disseminated MAC Infections
- 600 mg PO qd, in combination with ethambutol
Traveler's Diarrhea [Not FDA Approved]
Bronchiectasis [Not FDA Approved]
- 500 mg PO initially, then 250 mg PO QD x 4 days
Pharyngitis (Acute)[Non-FDA Approved]
COPD exacerbation[Non-FDA Approved]
- 500 mg PO qd x 3 days
- Alt: 500 mg PO initially, then 250 mg PO qd x 4 days
Pediatric Dosing
Acute Otitis Media
- 30 mg/kg PO as a single dose
- Alt: 10 mg/kg PO qd x 3 days
- Alt: 10 mg/kg as a single dose on day one, then 5 mg/kg qd x 4 days
Acute Bacterial Sinusitis
Community-Acquired Pneumonia
- 10 mg/kg PO as a single dose on day one, then 5 mg/kg qd x 4 days
Pharyngitis/Tonsillitis
Traveler's Diarrhea [Not FDA Approved]
- 10 mg/kg PO qd x 3 days [Max 500 mg/dose]
Bronchiectasis [Not FDA Approved]
- 10mg/kg PO initially, then 5 mg/kg PO QD x 4 days
- >50 Kg: Use Adult dose
Pharyngitis (Acute)[Non-FDA Approved]
- 12 mg/kg PO QD x 5 days [Max 500 mg/dose]
Chlamydia [Non-FDA Approved]
- Children between 1 month-9 yrs: 12-15mg/kg (1gm maximum dose) as single dose
- Children Aged
9 years or > 45kg: 1 gm PO as single dose
Chancroid [Non-FDA Approved]
- 20 mg/kg (up to 1 gm) PO as single dose
Pediatrics Pneumonia [Non-FDA Approved]
- 10 mg/kg PO as a single dose on day one, then 5 mg/kg qd x 4 days
[Outline]
- Azithromycin causes serious allergic reactions. Discontinue the drug if allergic reaction occurs and provide appropriate therapy. Monitor the patient for prolonged period as allergic symptoms may reappear
- Oral azithromycin should not be used in patients with pneumonia who have moderate to severe illness, or in those who have risk factors such as cystic fibrosis, nosocomially acquired infections, known or suspected bacteremia, patients requiring hospitalization, elderly or debilitated patients or patients with significant underlying health problems
- Clostridium difficile associated diarrhea (CDAD) ranging from mild diarrhea to fatal colitis may occur with azithromycin therapy as antibacterial agents alter the normal flora of the colon leading to overgrowth of C. difficile
- C. difficile produces toxins A and B which contribute to CDAD. Hypertoxin producing strains cause increased morbidity and mortality since these infections can be refractory to antibiotic therapy and may require colectomy. Careful medical examination is necessary since CDAD may occur > 2 months after administration of drug
- If CDAD is suspected/confirmed, discontinue the treatment and provide fluid, electrolyte, and protein supplementation along with antibiotics for C. difficile. Evaluate for surgical intervention as clinically needed
- Macrolides can cause prolonged QT interval and cardiac repolarization which may increase risk of developing cardiac arrhythmias and torsades de pointes.
- Prescribing antibiotics in the absence of proven or strongly suspected bacterial infection increases the risk of development of drug-resistant bacteria
- New onset or exacerbation of symptoms of myasthenia gravis have been reported in patients receiving azithromycin therapy
Cautions: Use cautiously in
- Severe renal impairment
- Hepatic impairment
- Myasthenia gravis
- QT prolongation
- Risk of QT prolongation
Pregnancy Category:B
Breastfeeding: Azithromycin should not cause adverse effects in breastfed infants as very small amounts are excreted in breast milk and higher doses of azithromycin are used in infants. Monitor the infant for possible effects on the gastrointestinal flora, such as diarrhea, and candidiasis. Unconfirmed epidemiologic evidence indicates maternal use of macrolide antibiotics during breastfeeding might increase the risk of hypertrophic pyloric stenosis in infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT) last accessed 5 Jan 2011. However manufacturer advises caution.
Pricing data from www.DrugStore.com in U.S.A.
- Zithromax Tri-Pak 500 MG TABS [Disp Pack] (PFIZER U.S.)
3 mg = $77.99
9 mg = $210.97 - Zithromax 250 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $346
90 mg = $915.92 - Zithromax 200 MG/5ML SUSR [Bottle] (PFIZER U.S.)
30 5ml = $55.99
90 5ml = $154.97 - Zithromax 500 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $675.99
90 mg = $1926.01 - Zithromax 1 GM PACK [Box] (PFIZER U.S.)
3 gm = $127.99
9 gm = $365.97 - Zithromax Z-Pak 250 MG TABS [Disp Pack] (PFIZER U.S.)
6 mg = $70.99
18 mg = $209.98 - Zithromax 100 MG/5ML SUSR [Bottle] (PFIZER U.S.)
15 5ml = $49.99
45 5ml = $139.97 - Zithromax 200 MG/5ML SUSR [Bottle] (PFIZER U.S.)
15 5ml = $53.99
45 5ml = $149.96 - Zithromax 600 MG TABS [Bottle] (PFIZER U.S.)
30 mg = $721.18
90 mg = $2051.26
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
