Currently, Azithromycin is one of the most popular and reasonable antibacterial medicines. It is in use mostly for treatment of various bacterial infections of respiratory apparatus. The medicine may be in use for treatment both of adults and of children.
What is Azithromycin?
Azithromycin is an azalide, a type of macrolide organic substance. Early in the 80s, pharmacists of the “Pliva” Yugoslav company synthesized the medicine. Later, it was sold under the trademark Sumamed and it was one of the most effective antibiotics in the world market. In 2005, the license of the medicine was run out. Currently, various pharmaceutical companies all around the world as well as English producers produce many analogs of Azithromycin such as Zithromax.
The antibiotic blocks bacterial elaboration of vitally important proteins blocking their growth and multiplying. Therefore, Azithromycin has bacteriostatic effect but not bactericidal action. However, the medicine is weaker than bactericidal antibiotics because bacteriastatis often causes destruction of bacteria colony. By the way, high doses of Azithromycin are bactericidal.
Pharmacological action of Azithromycin mostly simulates pharmacological action of Erythromycin though Azithromycin is derivative of Erythromycin. However, Azithromycin is mostly better than its precursor. First of all, the action of gastric juice does not destroy Azithromycin which acid resistance is about 300 times as much then resistance of Erythromycin. Moreover, Azithromycin causes much less side effects for gastrointestinal tract, than Erythromycin. The action of macrolides for the organism is more mild and benign, and the toxicity is less than the action and the toxicity of wide-used but old Penicillins. That is a good reason for using of the medicine for treatment of breastfed infants.
The second good for the organism property of the medicine is long-time excretion. A half of Azithromycin excretes from the organism in about 50 hours. This quality is much better than the analogic index of other antibiotics. That means that Azithromycin excretes from the organism for a rather long time. The medicine acts often in 5-7 days after the course of treatment is over. It is very important for treatment of severe and long infections at high probability of relapse. This action of the medicine reduces a frequency of its taking and duration of the course of treatment. Besides, low excretion of the medicine reduces the liver load, which is important for the patients suffering from various disorders of this organ.
However, the medicine absorbs into blood very quickly although duration of its concentration in the organism takes long time. Maximum concentration of Azithromycin is in 2.5 hours after taking.
The medicine accumulates mostly in tissues and in the focus of infection but it does not accumulate in the blood plasma. This is another important characteristic of the medicine. The research reveal that concentration of the substance at the infected tissues is about 30% higher than concentration in healthy tissues. Such a good antibiotic capacity as looking for the focus of infection distinguishes it from many other drugs distributing everly in tissues and fluids. It is concerned with the capacity of the substance to penetrate into phagocytes and macrophages and to penetrate into the tissues infected with bacilli combining with them.
Besides, it is very important that Azithromycin acts inside and outside of the organism cells. That means, that it may influence on bacteria, i.e. intracellular parasites, such as mycoplasma and chlamydia.
Use of Azithromycin
The antibiotic has spectrum of effects and acts against various bacteria such as gram-negative bacteria, gram-positive bacteria, aerobes and anaerobes. There are few bacilli with resistance to the antibiotic. They are some streptococcus and staphylococcus strains, salmonella, and shigella.
There are the next sensitive to the medicine influence bacteria:
- streptococcus,
- staphylococus,
- legionella,
- chlamydia,
- mycoplasma,
- toxoplasma gondii,
- clostridium,
- borrelia,
- haemophilus influenzae.
Indications
Medicine is in use for treatment infection diseases of:
- upper respiratory airway (throat, nasopharynx, and paranasal sinus),
- lower respiratory airway (bronchi and trachea),
- lungs,
- urogenital organs,
- skin.
Diseases of respiratory apparatus when the medicine is prescribed:
- bronchitis
- pneumonia (as well as athypical pneumonia),
- pharyngitis,
- rhinitis,
- sinusitis,
- scarlet fever,
- otitis media,
- highmoritis
The medicine may be in use for treatment of the next diseases of urogenital organs:
- urethritis,
- cervicitis,
- cystitis,
- adnexitis,
- prostatitis.
The medicine may be in use for treatment of early borreliosis (Lyme disease), various skin infections, and soft parts infection (erysipelas, impetigo, dermatosis, and medium severity acne).
At the composition of combination therapy, the medicine may be in use to destroy the Helicobacter pylori bacteria, which causes various stomach diseases such as gastritis and ulcer.
Most of opinions of patients about medicine are positive. Many patients notice, that medicine acts against the symptoms of chill diseases.
Product Description
There are various forms of medicine. They are film coat pills, resorption pills, capsules, suspension for children, and powder for parenteral solution. However, the Zithromax pills and capsules are mostly in use. The doses of active substance are 100 mg, 250 mg, and 500 mg.
Contraindications
There are some contraindications of Azithromycin. First of all, it is necessary to prescribe medicine for pregnant women carefully. The fact is the medicine penetrates into hemato-testicular barrier. Experiments of the medicine revealed that if pregnant women took it, there were no more often deviations of prenatal development. However, in the present state of affairs, it is better to consult a specialist. It is necessary to do the same if taking the medicine when nursing.
People younger than 12 years old should not take the medicine;
There are also contraindications of the medicine for the people suffering from severe kidney or liver failure, or from macrolide intolerance, or when lactation.
It is necessary to prescribe the medicine carefully for arrhythmia, for longer QT interval, or if simultaneous taking of digoxin and warfarin.
Side Effects
Side effects of the medicine are rare. However, they are possible. Such GIT disorders as stomachache, abdominal pain, diarrhea, sickness, constipation, and sometimes vomiting are the most often. It is necessary to remember that Azithromycin influent on normal intestinal microflora causing resistant dysbacteriosis like every antibiotic. Therefore, it is necessary to combine antibiotic therapy with probiotic medicine to restore intestinal microflora. Skin allergic reactions, headache, candidiasis, female vaginitis, flavor reversion, olfaction reversion, giddiness, and insomnia are possible symptoms.
Blood composition, ventricular tachycardia, and changed QT interval are also possible symptoms. Anginoneurotic edema, anaphylactic shock, pathological kidney changes, and liver necrosis are very rare symptoms.
Prescribing Information
Generally, necessary dose of medicine for treatment of acute respiratory diseases is 500 mg per day. It is better to take medicine at the same time, once per 24 hours. The course of treatment is usually short. It takes 3-5 days.
For skin infections, soft parts infections, and Lyme disease, it is necessary to take 1 g of medicine at the first day of treatment and it is necessary to take 500 g of medicine during the next 4 days of treatment. In these cases, it is also necessary to take medicine once a day.
For treatment of acne, it is necessary to take 0.5 g medicine during the first 3 days of treatment that means that it is necessary to take one capsule or a 500 mg pill a day or 2 pills of Azithromycin or 250 mg pill a day. Then, it is necessary to break treatment for 4 days and then it is necessary to take 0.5 g weakly. The course of treatment takes 10 weeks. During 10 weeks, it is necessary to take 500 mg pill or 12 pills. It is enough to take the 1 g dose of the medicine for treatment of light forms of urethritis and cervicitis caused by chlamydia.
When combined Helicobacter Pylori therapy, the necessary dose of Azithromycin to take is 1 g of medicine per three times during 3 days.
For respiratory infections, skin infections, and soft parts infections, it is prescribed for children younger than 12 years old whose body weight is more than 45 kg to take 500 g of medicine or three pills during 3 days.
It is necessary to calculate a dose of medicine for children whose body weight is less than 45 kg basing on the weight that means 10 mg/kg per day. The course of treatment is 3 days.
According to the prescription, for moderate disorders of kidney functions, it is not necessary to correct the dose.
It is necessary to notice that meal influences on medicine assimilability. It is necessary to take it for 1-2 hours before meal or in 2 hours after meal.
Antacydes and alcohol also reduce concentration of medicine in blood. If simultaneous taking of antacydes and Azithromycin, the interval of taking of the medicines is necessary to be 2 hours. Simultaneous taking of the medicine and alcohol is also not recommended.
If combined taking, tetracyclines and chloramphenicol enhance action of the medicine. The medicine increases concentration of digoxin; the medicine is incompatible with heparin.
