Azithromycin belongs to macrolide antibiotics (macrolides). Actually, it is chemically azalide, but its mechanism and range of antimicrobial activity are similar to that of older macrolides. Azithromycin is a relatively new representative of this group. It was developed to avoid some of the disadvantages of erythromycin.

Action of azithromycin

Azithromycin has a 15-membered ring resulting from the incorporation of an amino group into the erythromycin lactone ring. Thanks to these modifications, it achieves a high concentration in the tissues, which allows the therapy to be shortened to 3-5 days.

Azithromycin is also more stable than erythromycin in the acidic environment of the stomach. The mechanism of action of azithromycin is based on the inhibition of protein synthesis in a bacterial cell as a result of the attachment to the 50S subunit of the ribosome.

Binding of an antibiotic to the ribosome leads to the dissociation of the transport RNA (tRNA), which prevents the elongation of the peptide chain, thus interfering with protein synthesis and inhibiting bacterial growth.

Indications for the use of azithromycin

This antibiotic is indicated for the treatment of a range of infections caused by microorganisms sensitive to azithromycin. These include:

  • upper respiratory tract infections,
  • lower respiratory tract infections (acute bronchitis, exacerbation of chronic bronchitis, mild to moderately severe pneumonia, including interstitial pneumonia),
  • skin and soft tissue infections (erysipelas, impetigo and secondary pyoderma, erythema migrans).

Contraindications to the use of azithromycin

The use of this medicinal product is contraindicated in patients with hypersensitivity to azithromycin, erythromycin, or any macrolide antibiotic.

Available preparations

The drug is available as oral tablets or granules for suspension. Azithromycin, like any antibiotic, can only be obtained with a prescription and should be used strictly according to the doctor's instructions.

Azithromycin dosage

The drug should be administered orally. The tablets are taken once a day, at least 1 hour before or 2 hours after eatingmeal. Swallow the tablets whole. You cannot modify the dosage on your own, shorten or extend the therapy.

Side effects of azithromycin

May experience gastrointestinal disturbances:

  • nausea,
  • diarrhea,
  • abdominal pains,
  • vomiting and gas,
  • hypersensitivity reactions (rash, angioedema),
  • rarely transient cholestatic jaundice,
  • transient increase in liver enzymes.

Clostridium difficile associated diarrhea (CDAD) has been reported with the use of nearly all antibiotics, including azithromycin. This complication can range from mild diarrhea to fatal colitis.

The use of antibacterial drugs alters the normal bacterial flora in the colon, leading to overgrowth of C. difficile. C. difficile bacteria produce toxins A and B, which are involved in the development of CDAD.

Increases in cardiac repolarization and QT interval have also been observed with other macrolide antibiotics, indicating a risk of arrhythmias and torsades de pointes.

A similar effect of azithromycin in patients at increased risk for prolonged cardiac repolarization cannot be ruled out.

Interaction with other drugs

  • Cisapride is metabolized in the liver by the enzyme CYP3A4. Macrolide antibiotics, such as azithromycin, inhibit the action of this enzyme, so concomitant use of azithromycin with cisapride may cause QT prolongation, ventricular arrhythmias and torsades de pointes.
  • Digoxin levels should be monitored in patients receiving concomitant administration of azithromycin and digoxin as they may increase.
  • Increased bleeding tendency has been reported with the concomitant use of azithromycin and warfarin or oral coumarin-type anticoagulants. In this case, pay attention to frequent monitoring of prothrombin time.
  • Some macrolide antibiotics also affect the metabolism of cyclosporine. If combination therapy is considered warranted, monitor ciclosporin levels.
  • In patients receiving ergot derivatives, the concomitant use of some macrolide antibiotics may accelerate the onset of ergotism. There are no data on the potential for an interaction between ergot alkaloids and azithromycin. However, due to the theoretical possibility of ergotism, azithromycin should not be used concomitantlyand ergot derivatives.

Pregnancy and breastfeeding

Azithromycin crosses the placenta. There are no adequate and well-controlled studies in pregnant women. Azithromycin passes into breast milk. It is recommended that you do not breastfeed during and for up to two days after stopping treatment with azithromycin.

Impact on driving

There is no evidence that azithromycin may affect the ability to drive or use machines. When performing such activities, you should take into account the possibility of side effects such as dizziness and convulsions.

Storing medicine

The drug should be stored in accordance with the manufacturer's recommendations in the drug package insert. Pay attention to the storage conditions of the already prepared suspension.

Category:

He alth