Nursing & Healthcare Directories on: The Nursefriendly
Prescription Drug & Medication Index
Azithromycin, Zithromax

This page was prepared by Tami Skinner, LPN Internet Nursing Guide
Michigan Nurses, Pediatrics, Respiratory, Home Health, Medical-Surgical, Long Term Care
http://www.nursefriendly.com/skinner/

Azithromycin (Zithromax) Pharmacokinetics: rx list: "Adults Following oral administration, azithromycin is rapidly absorbed and widely distributed throughout the body. Rapid distribution of azithromycin into tissues and high concentration within cells result in significantly higher azithromycin concentrations in tissues than in plasma or serum.The pharmacokinetic parameters of azithromycin capsules in plasma after a loading dose of 500 mg (2¾250 mg capsules) on day one followed by 250 mg (1-250 mg capsule) q.d. on days two through five in healthy young adults (age 18-40 years old) are portrayed in TABLE 1.MicrobiologyAzithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interfering with microbial protein synthesis. Nucleic acid synthesis is not affected. Azithromycin concentrates in phagocytes and fibroblasts as demonstrated by in vitro incubation techniques. Using such methodology, the ratio of intracellular to extracellular concentration was >30 after one hour incubation. In vivo studies suggest that concentration in phagocytes may contribute to drug distribution to inflamed tissues.Azithromycin has been shown to be active against most strains of the following microorganisms, both in vitro and in clinical infections as described in the INDICATIONS AND USAGE. Gram-Positive Aerobes."
http://www.rxlist.com/cgi/generic/azith_cp.htm


Before Receiving Azithromycin (Zithromax) : Health Touch: "In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For domperidone the following should be considered: Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to domperidone. Pregnancy- Pregnancy- domperidone has not been studied in pregnant women. However, domperidone has not been shown to cause birth defects or other problems in animal studies. Breast-feeding— Breast-feeding—Domperidone passes into the breast milk, but it is not known if domperidone will cause unwanted effects in the newborn. It may be necessary for you to take another medicine or to stop breast-feeding during treatment. Be sure you have discussed the risks and benefits of the medicine with your doctor. Children—Children—studies on this medicine have been done only in adult patients, and there is no specific information comparing use of domperidone in children with use in other age groups. Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing the use of domperidone in the elderly with use in other age groups. Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your doctor or pharmacist if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine, especiallyMonoamine oxidase (MAO) inhibitors (furazolidone [e.g., Furoxone], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegilene [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) Other medical problems—The presence of other medical problems may affect the use of domperidone. Make sure you tell your doctor if you have any other medical problems, especiallyBleeding from the stomach or other problems involving the bowels Pituitary (brain) tumor Liver disease Medicine sensitivity to domperidone"
http://www.healthtouch.com/bin/EContent_HT/drugShowLfts.asp?fname=usp0034.htm&title=Zithromax&cid=HT


Azithromycin (Zithromax) Promising As Rosacea Treatment: Dermatology Times: "Seville, Spain -- A small pioneering study suggests oral azithromycin (Zithromax) improves the symptoms of acne rosacea at least as effectively as other antibiotics. "Since azithromycin given three times weekly successfully treats acne vulgaris, we tried it with rosacea," said Adolfo Fernandez-Obregon M.D., a New Jersey dermatologist in private practice. He presented his findings in a poster at the recent Fifth International Conference on the Macrolides, Azalides, Streptogramins, Ketolides, and Oxazolidinones. Ten adults who had responded poorly to standard treatment agreed to receive oral azithromycin alone for rosacea -- "a first," noted Dr. Fernandez-Obregon, who heads the Hudson Dermatology and Skin Cancer Center in Hoboken. "The drug had not been evaluated for the treatment of rosacea." The three men and seven women, ranging in age from 32 to 76 years, were instructed to take a single 250-mg dose of azithromycin three times a week. The only topical agent they used was a commercially available soap substitute for washing. They took no medication that could affect rosacea."
http://www.findarticles.com/cf_dls/m0UMR/4_21/61908784/p1/article.jhtml


comprehensive information and CLINICAL STUDIES IN PEDIATRIC PATIENTS taking Azithromycin (Zithromax) : Kids ears: "In a double-blind, controlled clinical study of acute otitis media performed in the United States, azithromycin (10 mg/kg on Day 1 followed by 5 mg/kg on Days 2-5) was compared to an antimicrobial/beta-lactamase inhibitor. In this study, very strict evaluability criteria were used to determine clinical response and safety results were obtained. For the 553 patients who were evaluated for clinical efficacy, the clinical success rate (i.e., cure plus improvement) at the Day 11 visit was 88% for azithromycin and 88% for the control agent. For the 521 patients who were evaluated at the Day 30 visit, the clinical success rate was 73% for azithromycin and 71% for the control agent. In the safety analysis of the above study, the incidence of adverse events, primarily gastrointestinal, in all patients treated was 9% with azithromycin and 31% with the control agent. The most common side effects were diarrhea/loose stools (4% azithromycin vs. 20% control), vomiting (2% azithromycin vs. 7% control), and abdominal pain (2% azithromycin vs. 5% control). Efficacy Protocol 2 In a noncomparative clinical and microbiologic trial performed in the United States, where significant rates of beta-lactamase producing organisms (35%) were found, 131 patients were evaluable for clinical efficacy. The combined clinical success rate (i.e., cure and improvement) at the Day 11 visit was 84% for azithromycin. For the 122 patients who were evaluated at the Day 30 visit, the clinical success rate was 70% for azithromycin."
http://www.kidsears.com/frprescribeinfo.htm

Azithromycin (Zithromax) Side effects: AIDS info NYC: "Azithromycin can cause mild gastrointestinal symptoms such as nausea and diarrhea, as well as dizziness and sensitivity to sunlight. A possible side effect of azithromycin can be hearing loss. Azithromycin appears to have no side effects involving the liver or other major organs.DosageTo treat toxoplasmosis, azithromycin is used in combination with pyrimethamine at an initial dose of 1000 mg followed by 500 mg per day. Azithromycin used alone has been associated with early relapse. To treat MAC, azithromycin has been studied at 500 mg per day with promising results in individuals taking it for 30 days. Some individuals may develop azithromycin-resistant strains of MAC. To treat chlamydia, azithromycin is given in a single 1000 mg oral dose."
http://www.aidsinfonyc.org/network/access/drugs/azit.html


Why do people with hiv take Azithromycin (Zithromax) : AIDS Infonet: "Azithromycin is used for mild or moderate bacterial infections. It works against several different bacteria, especially chlamydia, hemophilus and streptococcus. These bacteria can infect the skin, nose, throat, and lungs. They can also be transmitted through sexual activity and cause infections in the genital area.Many germs live in our bodies or are common in our surroundings. A healthy immune system can fight them off or keep them under control. However, HIV infection can weaken the immune system. Infections that take advantage of weakened immune defenses are called "opportunistic infections." People with advanced HIV disease can get opportunistic infections. See Fact Sheet 500 for more information on Opportunistic Infections.One opportunistic infection in people with HIV is MAC. This stands for mycobacterium avium complex. See Fact Sheet 510 for more information on MAC. People who have a T-cell count of less than 75 may develop MAC.Azithromycin is often used with another antibiotic to treat MAC. It can also be used to prevent MAC infection. If your T-cell count is below 75, talk to your doctor about using azithromycin.Some people are allergic to azithromycin and similar antibiotics. Be sure to tell your doctor if you are allergic to erythromycin or other antibiotics."
http://www.aidsinfonet.org/530-azithromycin.html


Azithromycin (Zithromax) dosage information: ASSN: "Adults: Oral susp: take 1 hour before or 2 hours after meals; tabs and packets may be taken without regard to meals. Use packets only for doses equal to 1 gram. Respiratory, skin and skin structure: over 16 years: 500 mg once daily for 1 day, then 250 mg once daily for 4 days. Nongonococcal urethritis, cervicitis: over 16 years: 1 g as a single dose. Urethritis, cervicitis due to N. gonorrhoeae: 2 g as a single dose. MAC prophylaxis: 1.2 g once weekly. Children: Take 1 hour before or 2 hours after meals. Use oral suspension (not packets). Otitis media, community-acquired pneumonia: under 6 months, not recommended; over 6 months: 10 mg/kg (maximum 500 mg/day) once daily for 1 day, then 5 mg/kg (maximum 250 mg/day) once daily for 4 days. Pharyngitis/tonsillitis: under 2 years, not recommended; over 2 years: 12 mg/kg (maximum 500 mg/day) once daily for 5 days. MAC prophylaxis: see literature. Also: ZITHROMAX INJECTION Rx Azithromycin 500 mg/vial; for intravenous infusion after reconstitution and dilution."
http://www.ama-assn.org/special/hiv/treatmnt/druginfo/zithro.htm


Polymyositis and Azithromycin (Zithromax) : Rheumatic.org: "I started begging my doctor for Zithromax, as each time I took it my symptoms eased, and why did my CPK go down instead of up before I started on any prednisone or other medication? I was up to 80mg per day of prednisone and wasn't getting any better so I changed doctors. I had already had a muscle biopsy and a "EMG" (that was quite the barbaric torture test). Then I needed a liver biopsy before I could go on methotrexate. And, why not give me 1000 mg of prednisone a day for three days, through an IV while I'm in the hospital? What a nightmare that whole deal was. Prednisone is to reduce swelling, which I had no evidence of with the muscle biopsy. But the first rheumatologist made some excuses to satisfy himself on that one. Funny how you find these things out after it's too late. Anyway, I went progressively down on prednisone and up on methotrexate."
http://rheumatic.org/steve.htm


Azithromycin (Zithromax) How It Works: virtual drug store: "Azithromycin or Zithromax is a macrolide antibiotic like erythromycin. It interferes with bacterial reproduction, thus killing the bacteria. Because Azithromycin or Zithromax is an erythromycin, cross resistance occurs - if another erythromycin didn't work, Azithromycin or Zithromax won't either. However, compared to other erythromcyins, Azithromycin or Zithromax does have greater tissue penetration and lasts longer. Drug Interactions: Azithromycin or Zithromax is able to reduce the liver's metabolism of the non sedating antihistamines terfenadine and astemizole. Increased levels of these antihistamines in the body can result in potentially fatal heart beat irregularities."
http://www.virtualdrugstore.com/infection/azithromycin.html