Precautions Before Starting Azithromycin
- Are you pregnant or breastfeeding?
- Do you have problems with the way your liver or kidneys work?
- Do you know if you have an unusual heart rhythm?
- Are you taking warfarin?
- Are taking any other medicines? This includes any medicines you are taking which you can buy without a prescription, as well as herbal and complementary medicines.
If so, its important that you tell your doctor or pharmacist before you start azithromycin. Sometimes a medicine isnt suitable for a person with certain conditions, or it can only be used with extra care.
Special Warnings And Precautions For Use
In the treatment of pneumonia, azithromycin has been shown to be safe and effective only in the treatment of community acquired pneumonia of mild severity due to Streptococcus pneumoniae or Haemophilus influenzae in patients appropriate for outpatient oral therapy. Azithromycin should not be used in patients with pneumonia who are judged to be inappropriate for outpatient oral therapy because of moderate to severe illness or risk factors such as any of the following: patients with cystic fibrosis patients with nosocomially acquired infections patients with known or suspected bacteraemia patients requiring hospital admission elderly or debilitated patients or patients with significant underlying health problems that may compromise their ability to respond to their illness .
Usual Adult Dose For Mycoplasma Pneumonia
Community-acquired pneumonia:Oral:-Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5-Extended-release: 2 g orally once as a single doseParenteral: 500 mg IV once a day as a single dose for at least 2 days, followed by 500 mg orally to complete a 7- to 10-day course of therapyComment: Extended-release formulations should be taken on an empty stomach.Uses:-Treatment of mild community acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy-Treatment of community-acquired pneumonia due to C pneumoniae, H influenzae, Legionella pneumophila, Moraxella catarrhalis, M pneumoniae, or S pneumoniae in patients who require initial IV therapy
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Summary Of The Evidence
There is no evidence relating to patient values and preferences but the Guideline Development Group agreed that there is probably no variability in the values people place on the outcomes. Research related to other conditions indicates that adherence may be improved with simpler medication regimens. The GDG therefore agreed that azithromycin may be more acceptable to patients since it is a single dose regimen . There is little to no evidence for equity issues and feasibility. Resistance in other infections that often co-occur with chlamydia may restrict the use of some medicines, such as ofloxacin. For many of these medicines, costs may differ between countries in places with high incidence of chlamydia, the cost differences between azithromycin and doxycycline may be large due to greater numbers of people requiring treatment.
In summary, there was moderate quality evidence for trivial differences in benefits and harms between azithromycin and doxycycline, and although the cost of azithromycin is higher, the single dose may make it more convenient to use than doxycycline. While the differences are also trivial with the other medicines, the evidence is low quality and these are therefore provided as alternatives, with the exception of delayed-release doxycycline, which is currently expensive.
See for list of references of reviewed evidence, and for details of the evidence reviewed, including evidence profiles and evidence-to-decision frameworks .
Chlamydial Infection Among Adolescents And Adults
Chlamydial infection is the most frequently reported bacterial infectious disease in the United States, and prevalence is highest among persons aged 24 years . Multiple sequelae can result from C. trachomatis infection among women, the most serious of which include PID, ectopic pregnancy, and infertility. Certain women who receive a diagnosis of uncomplicated cervical infection already have subclinical upper genital tract infection.
Asymptomatic infection is common among both men and women. To detect chlamydial infection, health care providers frequently rely on screening tests. Annual screening of all sexually active women aged < 25 years is recommended, as is screening of older women at increased risk for infection . In a community-based cohort of female college students, incident chlamydial infection was also associated with BV and high-risk HPV infection . Although chlamydia incidence might be higher among certain women aged 25 years in certain communities, overall, the largest proportion of infection is among women aged < 25 years .
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Is It Right For You
As with just about every medication, there will be certain groups of people for whom it is not suitable. Thankfully, there is a range of antibiotic treatments that have been proven effective in the treatment of Chlamydia infection, so if it turns out that Azithromycin isnt for you, there will be another course of treatment you can take that will be just as effective.
Azithromycin May Interact With Other Medications
Azithromycin oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs youre taking. If you have questions about whether a drug youre taking might interact with azithromycin, talk to your doctor or pharmacist.
Examples of drugs that can cause interactions with azithromycin are listed below.
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Warnings For People With Certain Health Conditions
For people with myasthenia gravis: If you have myasthenia gravis, taking this drug may worsen your symptoms. Be sure to discuss your condition with your doctor before taking azithromycin.
For people with certain heart problems: If you have an abnormal heart rhythm, including a condition called QT prolongation, taking this drug can increase your risk of having an arrhythmia that may be fatal. People with decompensated heart failure are also at risk. Ask your doctor if this drug is safe for you.
Who Can And Can’t Take Doxycycline
Doxycycline can be taken by adults and children over 12 years old. Doxycycline is not usually recommended in pregnancy or when breastfeeding.
It isn’t suitable for some people. To make sure this medicine is safe for you, tell your doctor if you have:
- ever had an allergic reaction to doxycycline or any other medicine in the past
- kidney problems
- myasthenia gravis, an illness that causes severe muscle wasting
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Other Factors To Consider :
- What should be the gap between two doses?
- How much dose you should take?
- Your metabolic rate If your metabolism is slow than it will increase the duration of medicine in your system.
- Your age and health In general, older age and poor health increase the amount of time the medication stays in your system.
- Bodyweight the higher the medicine, the longer the medicine stays in your system.
Interactions With Other Medicines And Other Forms Of Interactions
Azithromycin does not interact significantly with the hepatic cytochrome P450 system. It is not believed to undergo the pharmacokinetic drug interactions as seen with erythromycin and other macrolides. Hepatic cytochrome P450 induction or inactivation via cytochrome metabolite complex does not occur with azithromycin.
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Usual Adult Dose For Acne
IV:-Initial dose: 200 mg IV on the first day, given in 1 or 2 infusions-Maintenance dose: 100 to 200 mg/day IVORAL:Most Products:-Initial dose: 200 mg orally on the first day, given in 2 divided doses -Maintenance dose: 100 mg orally once a day OR 50 mg orally every 12 hours—More severe infections : 100 mg orally every 12 hoursDoryx MPC:-Initial dose: 240 mg orally on the first day, given in 2 divided doses -Maintenance dose: 120 mg orally once a day or 60 mg orally every 12 hours—More severe infections : 120 mg orally every 12 hours
How Should This Medicine Be Used
Azithromycin comes as a tablet, an extended-release suspension , and a suspension to take by mouth. The tablets and suspension are usually taken with or without food once a day for 15 days. When used for the prevention of disseminated MAC infection, azithromycin tablets are usually taken with or without food once weekly. The extended-release suspension is usually taken on an empty stomach as a one-time dose. To help you remember to take azithromycin, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take azithromycin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Shake the liquid well before each use to mix the medication evenly. Use a dosing spoon, oral syringe, or measuring cup to measure the correct amount of medication. Rinse the measuring device with water after taking the full dose of medication.
If you receive azithromycin powder for suspension in the single-dose, 1-gram packet, you must first mix it with water before you take the medication. Mix the contents of the 1-gram packet with 1/4 cup of water in a glass and consume the entire contents immediately. Add an additional 1/4 cup of water to the same glass, mix, and consume the entire contents to ensure that you receive the entire dose.
Ask your pharmacist or doctor for a copy of the manufacturer’s information for the patient.
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Usual Adult Dose For Legionella Pneumonia
Community-acquired pneumonia:Oral:-Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5-Extended-release: 2 g orally once as a single doseParenteral: 500 mg IV once a day as a single dose for at least 2 days, followed by 500 mg orally to complete a 7- to 10-day course of therapyComment: Extended-release formulations should be taken on an empty stomach.Uses:-Treatment of mild community acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy-Treatment of community-acquired pneumonia due to C pneumoniae, H influenzae, Legionella pneumophila, Moraxella catarrhalis, M pneumoniae, or S pneumoniae in patients who require initial IV therapy
Diagnosis And Treatment Of Chlamydia Trachomatis Infection
KARL E. MILLER, M.D., University of Tennessee College of Medicine, Chattanooga, Tennessee
Am Fam Physician. 2006 Apr 15 73:1411-1416.
Chlamydia trachomatis infection most commonly affects the urogenital tract. In men, the infection usually is symptomatic, with dysuria and a discharge from the penis. Untreated chlamydial infection in men can spread to the epididymis. Most women with chlamydial infection have minimal or no symptoms, but some develop pelvic inflammatory disease. Chlamydial infection in newborns can cause ophthalmia neonatorum. Chlamydial pneumonia can occur at one to three months of age, manifesting as a protracted onset of staccato cough, usually without wheezing or fever. Treatment options for uncomplicated urogenital infections include a single 1-g dose of azithromycin orally, or doxycycline at a dosage of 100 mg orally twice per day for seven days. The recommended treatment during pregnancy is erythromycin base or amoxicillin. The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommend screening for chlamydial infection in women at increased risk of infection and in all women younger than 25 years.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Azithromycin or doxycycline is recommended for the treatment of uncomplicated genitourinary chlamydial infection.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Azithromycin or doxycycline is recommended for the treatment of uncomplicated genitourinary chlamydial infection.
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Usual Adult Dose For Gonococcal Infection
Gonococcal urethritis and cervicitis:Immediate-release: 2 g orally onceUse: Treatment of mild to moderate urethritis and cervicitis due to Neisseria gonorrhoeaeUS Centers for Disease Control and Prevention Recommendations:Immediate-release:-Recommended regimen: 1 g orally once as a single dose plus ceftriaxone-Alternative regimen: 1 g orally once as a single dose plus cefixime
Azithromycin For Sinus Infection
People who are suffered from sinus most probably ask the doctor to prescribe an antibiotic. Acute sinus infections mostly last for about three-four weeks. Azithromycin is the most common antibiotic prescribed to treat sinus infections. There is evidence that Azithromycin works at its best level and quickly cure sinus infections. But it is not necessary that antibiotics can help sinus patients every time. Judicious usage of antibiotics is essential to cure sinus infections.
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Getting Treated For Chlamydia And Often Gonorrhea
If you have your own doctor, he will prescribe the antibiotics you need to treat chlamydia. If you dont have your own doctor, you can often find free or low-cost care at either a Planned Parenthood site or a community health clinic.
Listen carefully to the instructions for taking the medicine that you are given by the doctor or other healthcare provider, and follow them closely.
Ask questions if you dont understand something. Also, if you have other questions as you take your medicine, you can always call the pharmacist for help. They are often easier to reach than the doctor.
If you test positive for chlamydia, your healthcare provider is likely to also recommend that you be treated for gonorrhea. This is because the cost of treating gonorrhea is less than the cost of testing for the infection.
Duration Of Azithromycin In Your Body To Stay:
As per the studied done, Azithromycin medicine usually stays around 15 to 16 days in your days after the consumption of last dose.
There is a 68 hour elimination half-life of this tablet. The prolonged terminal elimination half-life is associated with high drug uptake and subsequent elimination from the tissue.
Approximately 5.5 times the elimination half-life is required to remove the drug from the system. Therefore, it will take about 15.5 days for 374 hours to be removed from the system.
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The Best Antibiotics For Chlamydia: First
Chlamydia can be easily treated and cured with antibiotics. However, not all antibiotics are effective.
The Centers for Disease Control and Prevention recommends doxycycline or azithromycin as first-choice antibiotic for the treatment of genital chlamydia. These medications are very effective for both acute and persistent infections.
Important note: To avoid reinfection, persons with chlamydia should abstain from sexual activity until they and their sex partners have completed the treatment.
Infant Pneumonia Caused By C Trachomatis
Chlamydial pneumonia among infants typically occurs at age 13 months and is a subacute pneumonia. Characteristic signs of chlamydial pneumonia among infants include a repetitive staccato cough with tachypnea and hyperinflation and bilateral diffuse infiltrates on a chest radiograph. In addition, peripheral eosinophilia occurs frequently. Because clinical presentations differ, all infants aged 13 months suspected of having pneumonia, especially those whose mothers have a history of, are at risk for , or suspected of having a chlamydial infection should be tested for C. trachomatis and treated if infected.
Diagnostic Considerations
Specimens for chlamydial testing should be collected from the nasopharynx. Tissue culture is the definitive standard diagnostic test for chlamydial pneumonia. Nonculture tests can be used. DFA is the only nonculture FDA-cleared test for detecting C. trachomatis from nasopharyngeal specimens however, DFA of nasopharyngeal specimens has a lower sensitivity and specificity than culture. NAATs are not cleared by FDA for detecting chlamydia from nasopharyngeal specimens, and clinical laboratories should verify the procedure according to CLIA regulations . Tracheal aspirates and lung biopsy specimens, if collected, should be tested for C. trachomatis.
Treatment
Erythromycin base or ethylsuccinate 50 mg/kg body weight/day orally divided into 4 doses daily for 14 days
Azithromycin suspension 20 mg/kg body weight/day orally, 1 dose daily for 3 days
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What Does The Research Say
A large 2012 cohort study found a small increase in the risk of cardiovascular death among people taking azithromycin. The risk was higher among those with other risk factors for heart disease, such as smoking, low physical activity levels, and a high body mass index .
The study reported that when compared with amoxicillin, there were 47 additional cardiovascular deaths per 1 million azithromycin prescriptions. Among people with the highest risk of heart disease, there were 245 more deaths per 1 million courses of azithromycin.
This suggests that other antibiotics, such as amoxicillin, may be a safer option for people with heart disease or certain types of heart arrythmias.
In 2018 , the FDA issued a warning about the long term use of azithromycin in people with certain blood or lymph node cancers who have stem cell transplants. Emerging research has suggested that azithromycin may increase the risk of cancer relapse in these people.
Following a stem cell transplant, some people take azithromycin to reduce the risk of an inflammatory lung condition called bronchiolitis obliterans syndrome. The FDA have not approved azithromycin for this use, however.
Rarely, azithromycin can cause liver toxicity. People should stop taking the drug and call their doctor if they develop any symptoms of liver problems, including dark urine, itching, or yellow eyes.
For Pharyngitis Or Tonsillitis
Adult dosage
Your doctor may prescribe 500 mg in a single dose on day 1, followed by 250 mg once per day on days 2 through 5.
Child dosage
The typical dosage is 12 mg/kg of body weight once per day for 5 days.
Child dosage
This drug should not be used for this condition in children who are younger than 2 years.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.
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