Azithromycin is a broad-spectrum macrolide antibiotic with a long half-life and a high degree of tissue penetration . It was initially approved by the FDA in 1991 .
It is primarily used for the treatment of respiratory, enteric and genitourinary infections and may be used instead of other macrolides for some sexually transmitted and enteric infections. It is structurally related to erythromycin .
Azithromycin [9-deoxo-9a-aza-9a-methyl-9a-homoerythromycin] is a part of the azalide subclass of macrolides, and contains a 15-membered ring, with a methyl-substituted nitrogen instead of a carbonyl group at the 9a position on the aglycone ring, which allows for the prevention of its metabolism. This differentiates azithromycin from other types of macrolides .
In March 2020, a small study was funded by the French government to investigate the treatment of COVID-19 with a combination of azithromycin and the anti-malaria drug hydroxychloroquine. The results were positive, all patients taking the combination were virologically cured within 6 days of treatment, however, larger studies are required.
Azithromycin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria in order to prevent the development antimicrobial resistance and maintain the efficacy of azithromycin .
Azithromycin is indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the microorganisms listed in the specific conditions below. Recommended dosages, duration of therapy and considerations for various patient populations may vary among these infections. Refer to the FDA label and "Indications" section of this drug entry for detailed information .
Adults:
Acute bacterial exacerbations of chronic obstructive pulmonary disease due to Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae
Acute bacterial sinusitis due to Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae
Community-acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae or Streptococcus pneumoniae in patients appropriate for oral therapy
Pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in individuals who cannot use first-line therapy.
Uncomplicated skin and skin structure infections due to Staphylococcus aureus, Streptococcus pyogenes, or Streptococcus agalactiae. Abscesses usually require surgical drainage.
Urethritis and cervicitis due to Chlamydia trachomatis or Neisseria gonorrhoeae.
Genital ulcer disease in men due to Haemophilus ducreyi (chancroid). Due to the small number of women included in clinical trials, the efficacy of azithromycin in the treatment of chancroid in women has not been established.
Pediatric Patients
Acute otitis media caused by Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae
Community-acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae or Streptococcus pneumoniae in patients appropriate for oral therapy.
Pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in individuals who cannot use first-line therapy.
ZNA Middelheim, Antwerpen, Vlaanderen, Belgium
UZ Gent, Gent, Vlaanderen, Belgium
Jessa Ziekenhuis, Hasselt, Vlaanderen, Belgium
UZ Brussel, Brussel, Brussel Hoofdstedelijk Gewest, Belgium
Jessa Ziekenhuis, Hasselt, Vlaanderen, Belgium
AZ Groeninge Ziekenhuis, Kortrijk, Vlaanderen, Belgium
Respiratory Research Unit, Nottingham, Nottinghamshire, United Kingdom
Geta Eye Hospital, Geta, Kailali, Nepal
University Hospital for Pulmonology, Berne, Switzerland
Kantonsspital St. Gallen, St. Gallen, Switzerland
Universitätsspital Basel, Basel, Switzerland
Jessa Ziekenhuis, Hasselt, Vlaanderen, Belgium
Grand Hôpital de Charleroi, Gilly, Wallonië, Belgium
St. Augustinus Ziekenhuis, Antwerpen, Vlaanderen, Belgium
Douglas Campideli Fonseca, Lavras, Minas Gerais, Brazil
Respiratory Unit, Taiping Hospital, Taiping, Perak, Malaysia
Childrens Hospital Los Angeles, Los Angeles, California, United States
CFF Care Center & Pediatric Program Emory University, Atlanta, Georgia, United States
CFF Affiliate Program Children's Healthcare of Atlanta, Atlanta, Georgia, United States
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