Therapeutic action
Indications
- Trachoma, conjunctivitis due to Chlamydia trachomatis
- Cervicitis and urethritis due to Chlamydia trachomatis (in combination with a treatment for gonorrhoea), donovanosis, chancroid, early syphilis
- Cholera (if the strain is susceptible), typhoid fever, yaws, leptospirosis, louse-borne and tick-borne relapsing fevers
- Pertussis, diphtheria, pneumonia due to Mycoplasma pneumoniae and Chlamydophila pneumoniae
- Second-line treatment of shigellosis
- Streptococcal tonsillitis, acute otitis media, in penicillin-allergic patients only
Forms and strengths
- 250 mg and 500 mg tablets
- 200 mg/5 ml powder for oral suspension, to be reconstituted with filtered water
Dosage and duration
Trachoma, cholera, cervicitis and urethritis due to C. trachomatis, chancroid, early syphilis
- Child: 20 mg/kg (max. 1 g) single dose
- Adult: 1 g single dose (2 g single dose in early syphilis)
Yaws
- Child and adult: 30 mg/kg (max. 2 g) single dose
Conjunctivitis due to C.trachomatis
- Child: 20 mg/kg (max. 1 g) once daily for 3 days
- Adult:1 g once daily for 3 days
Typhoid fever
- Child: 10 to 20 mg/kg (max. 1 g) once daily for 7 days
- Adult: 500 mg to 1 g once daily for 7 days or 1 g on D1 then 500 mg once daily from D2 to D7
Donovanosis (granuloma inguinale)
- Adult: 1 g on D1 then 500 mg once daily until healing of lesions
Pertussis, pneumonia due to M.pneumoniae and C. pneumoniae
- Child: 10 mg/kg (max.500 mg) once daily for 5 days
- Adult: 500 mg on D1 then 250 mg once daily from D2 toD5
Leptospirosis
- Child: 10 mg/kg (max. 500 mg) on D1 then 5 mg/kg (max. 250 mg) once daily on D2 and D3
- Adult: 1 g on D1 then 500 mg once daily on D2 and D3
Shigellosis
- Child: 12 mg/kg (max.500mg) on D1 then 6 mg/kg (max. 250 mg) once daily from D2 to D5
- Adult: 500 mg on D1 then 250 mg once daily from D2 to D5
Diphtheria
- Child: 10 to 12 mg/kg (max. 500 mg) once daily for 14 days
- Adult: 500 mg once daily for 14 days
Relapsing fevers (louse-borne and tick-borne)
- Child: 10 mg/kg (max. 500 mg) single dose for louse-borne relapsing fever and once daily for 7 to 10 days for tick-borne relapsing fever
- Adult: 500 mg single dose for louse-borne relapsing fever and once daily for 7 to 10 days for tick- borne relapsing fever
Streptococcal tonsillitis, only in penicillin-allergic patients
- Child: 20 mg/kg (max. 500 mg) once daily for 3 days
- Adult:500 mg once daily for 3 days
Acute otitis media, only in penicillin-allergic patients
- Child: 10 mg/kg (max.500 mg) once daily for 3 days
Contra-indications, adverse effects, precautions
- Do not administer to patients with allergy to azithromycin or another macrolide, and to patients with severe hepatic impairment.
- May cause: gastrointestinal disturbances, heart rhythm disorders(QT prolongation), allergic reactions sometimes severe. In the event of allergic reaction, stop treatment immediately.
- Do not administer simultaneously with antacids(aluminium or magnesium hydroxide, etc.). Administer 2 hours apart.
- Avoid combination with drugs that prolong the QT interval (amiodarone, chloroquine, co- artemether, fluconazole, haloperidol, mefloquine, moxifloxacin, ondansetron, pentamidine, quinine, etc.).
- Administer with caution and monitor use in patients taking digoxin (increased digoxin plasma levels).
- Pregnancy and breast-feeding: no contra-indication
Remarks
Azithromycin is also used for septicaemia of pulmonary or gynaecological origin (child: 10 to 20 mg/kg (max. 1 g) once daily; adult:500 mg to 1 g once daily),in combination with other antibacterials.
Also comes in 250 mg or 500 mg capsules, to be taken one hour before or 2 hours after a meal.
Storage
– Below 25 °C
For the oral suspension(powder or reconstituted suspension): follow manufacturer’s instructions.