Generic Name : Azithromycin.

Trade Name     : Zithromax.

Drug Class      : Azithromycin.

Forms of The Drug

  1. Injection, Lyophilized Powder: 500mg/vial.
  2. Tablet: 250mg, 500mg.
  3. Oral Suspension: 100mg/5mL, 200mg/5mL.

Mechanism of Action

Azithromycin blocks the translocation of peptidyl-tRNA from the A-site to the P-site, which ultimately leads to the inhibition of bacterial growth and replication. Azithromycin is also effective against intracellular pathogens, such as chlamydia and mycoplasma, due to its ability to penetrate the cell membrane and concentrate within the cytoplasm.

Indications

  1. Respiratory tract infections such as pneumonia, bronchitis, and sinusitis.
  2. Skin and soft tissue infections such as cellulitis, impetigo, and erysipelas.
  3. Sexually transmitted infections such as chlamydia and gonorrhea.
  4. Ear infections particularly in children.
  5. Gastrointestinal infections such as traveler’s diarrhea and campylobacteriosis.
  6. Other infections such as mycobacterium avium complex (MAC) infections in people with HIV.

Contraindications

  1. Hypersensitivity.
  2. Liver disease: as the medication can worsen liver function.
  3. Kidney disease: as the medication is eliminated from the body through the kidneys.
  4. Heart rhythm disorders: as the medication can cause changes in heart rhythm, including QT prolongation.
  5. Myasthenia gravis: as the medication can worsen muscle weakness.

Side Effects

  1. Diarrhea (52.8%).
  2. Nausea (32.6%).
  3. Abdominal pain (27%).
  4. Loose stool (19.1%).
  5. Elevated ALT, AST, creatinine (4-6%).
  6. Elevated LDH, bilirubin (1-3%).

Drug Interaction

Other drugs that can affect azithromycin.

  1. Warfarin.
  2. Antacids contain aluminum or magnesium.
  3. CYP3A4 inhibitors include ketoconazole, itraconazole, erythromycin, and clarithromycin.
  4. CYP3A4 inducers include rifampin, carbamazepine, and phenytoin.
  5. Digoxin.
  6. Statins.
  7. Ergotamine or dihydroergotamine.
  8. Cyclosporine.

Precautions

  1. Pregnancy: Category B.
  2. Lactation: Azithromycin is excreted into breast milk in small amounts. While there is no evidence of harm to nursing infants, caution is still recommended when using azithromycin in lactating women.

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