Azithromycin Dihydrate is an azalide antibiotic, a subclass of the macrolide class. It hooks to the 50s ribosomal subunit of susceptible organisms and thus interferes with microbial protein synthesis. It demonstrated activity in vitro against a wide range of gram-positive and gram-negative bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus pyogenes (Group A), and other Streptococcal species, Haemophilus influenza and poronfluenzar Moraxella catarrhalis, anaerobes including Bacteroides fragilis, Escherichia col Bordetella pertussis, Bordetella parapertussis. Borrelia burgdorferi Haemophilus ducrey Neisseria gonorrhoeae and Chlamydia trachomatis. Azithromycin also demonstrates activity in vitro against Legionella pneumophila, Mycoplasma pneumonia, and hominis: Campylobacter sp Toxoplasma gondii and Treponema pallidum.Microbiology: Azithromycin is active against most isolates of the following microorganisms, both in vitro and in clinical infections:
Respiratory tract infections: For treating bacterial infections of the respiratory tract, such as bronchitis, pneumonia, and sinusitis.
Skin and soft tissue infections: Used to treat skin and soft tissue infections such as impetigo, cellulitis, and erysipelas.
Sexually transmitted infections: Certain sexually transmitted infections, such as chlamydia and gonorrhea.
Ear infections: Bacterial ear infections, such as otitis media.
Mycobacterial infections: Sometimes used with other drugs to treat mycobacterial infections such as tuberculosis and Mycobacterium avium complex (MAC) infection.
Gastrointestinal infections: Can treat gastrointestinal tract bacterial infections, such as traveler's diarrhea.
Dosage of Azithromycin Dihydrate
Consult a doctor before taking any medicine. Azithromycin Dihydrate can be taken orally and via injection. Oral Dosage for Adults: The standard dosage for adults is 500 mg for the first day or continuously for 3 days based on the condition. If needed, then 250 mg per day for 2 to 5 days can be taken. If you are sufferings from sexually transmitted diseases caused by Chlamydia trachomatis, then 500 mg once for the first day and followed by 250 mg once for the next 2 to 5 days. Children: Azithromycin is advised by 10 mg per kg body weight for those children who already passed 6 months for three days.If the body weight is 15 to 25 kg then the dosage is 200 mg (one teaspoonful) for three days. For 26 to 35 kg body weight, 300 mg (1.5 teaspoonfuls), and for 36 to 45 kg, 400 mg (2 teaspoonfuls). In case of typhoid fever, 500 mg daily (2.5 teaspoonfuls) for 7 to 10 days.
To make the suspension suitable for the child, you should follow the given Preparation method of suspension-
Step 01: Jiggle the bottle well to facilitate the powder. Otherwise, it will not mix with water properly.
Step 02: Mix boiled but cold water with the power according to the given mark of the bottle.
Step 03: Shake until powder is thoroughly mixed with water.
Azithromycin should be taken at least 1 hour before or 2 hours after a meal.
Antacid: If the patient takes antacid and Azithromycin at the same time, then he should take Azithromycin Dihydrate at least 1 hour before or 1 hour after taking the antacid.
Carbamazepine: In a pharmacokinetic interaction study in the fit human body, there was no noticeable change in the plasma levels of carbamazepine or its active metabolite.
Cyclosporin: Some affiliated macrolide antibiotics hinder the metabolism of cyclosporin. Without any information from pharmacokinetic studies of interactions between Azithromycin Dihydrate and cyclosporine, one must be careful before taking these two drugs. Cyclosporin levels should be observed, and the dose adjusted accordingly if co-administration is required.
Digoxin: Some macrolide antibiotics may cause impair the metabolism of digoxin. Therefore, digoxin levels must be noticed if patients take Azithromycin and digoxin.
Ergot derivatives: For the hypothetical prospect of ergotism, azithromycin and ergot derivatives should not be used at the same time.
Methylprednisolone: According to the pharmacokinetic interaction study on the human body, Azithromycin had no noticeable effects on the pharmacokinetics of methylprednisolone.
Theophylline: There is no interaction report when azithromycin and theophylline are taken. But theophylline levels must be monitored.
Warfarin: Azithromycin did not alter the anticoagulant effect of a single 15 mg dose of warfarin in healthy body. Azithromycin and warfarin may be co-administered, but the prothrombin time should be monitored as routinely performed.
Terfenadine: Azithromycin Dihydrate did not affect the pharmacokinetics of terfenadine at the recommended dose of 60 mg every 12 hours.
Those who have hypersensitive to Azithromycin, any elements of Azithromycin or any other macrolide antibiotic should not use Azithromycin Dihydrate. Co-administration of ergot derivatives and Azithromycin is contraindicated. Patients with hepatic diseases should not operate also.
Side Effects of Azithromycin Dihydrate
Azithromycin Dihydrate is a well-tolerated drug but some minor side effects may appear. The majority of side effects were:
Gastrointestinal in origin, with nausea
Abdominal discomfort (pain/cramps) can be seen.
And loose stools.
Because of allergic reactions in the human body, some rashes or spots may be seen on the face and body. Some cases of cholestatic jaundice may be observed.Hearing impairment: In some cases, when Azithromycin Dihydrate is used in higher dosages, hearing impairment can be seen.
Precautions & Warnings
As with erythromycin and other macrolides, rare serious allergic reactions, including angioneurotic edema and anaphylaxis, have been reported. Some of these reactions with Azithromycin Dihydrate have resulted in recurrent symptoms and require a long observation and treatment period.
Pregnancy and Lactation
According to the pregnancy Category of medicine, Azithromycin is B. fetus is never hurt because of using Azithromycin which is already proved in animal reproduction studies. But studies do not always represent every pregnant woman’s situation. So it should be used in that time when perfect alternatives are not available. Even caution should be kept in mind during lactation.
Use in Special Populations
Use in renal impairment: No dose adjustment is needed in slight renal impairment (creatinine clearance >40 ml/min), but there are no data regarding azithromycin in patients with more severe renal impairment, so be careful before using azithromycin.
Use in hepatic impairment: As the liver is the principal route of excretion of azithromycin, it should not be used in patients with hepatic disease.
Effects on ability to drive and use machines: No evidence suggests that azithromycin may affect a patient’s ability to drive or operate machinery.
There is no data on overdosage with Azithromycin Dihydrate. But some symptoms can be seen because of overdosages such as hearing loss, severe nausea, vomiting, and diarrhea.StorageKeep in a dry place away from light and heat. Keep out of the reach of children.