Application
Azithromycin finds its use in the fight against respiratory tract infections. Most often used to treat the following diseases:
- pneumonia (pneumonia),
- exacerbation of chronic bronchitis,
- sinusitis,
- acute tonsillitis,
- pharyngitis.
Moreover, azithromycin is used to treat acute middle ear infections, skin and wound infections, Lyme borreliosis, bacterial conjunctivitis, chlamydial urethritis, and for the prevention of mycobacterial infections in immunocompromised patients.
In dogs it is used to treat canine papillomatosis.
Mechanism of action
Macrolide antibiotics interfere with the process of protein synthesis by binding to the 50S subunit of bacterial ribosomes. With such a connection, translocation is blocked, that is, the shift of peptidyl t-RNA from the acceptor site to the donor site. This leads to premature interruption of protein biosynthesis and, consequently, to a bacteriostatic effect.
Azithromycin is slightly less effective against gram-positive than against gram-negative bacteria.
A feature of azithromycin is its long residence time in affected tissues, such as the neck, throat, and respiratory tract. And, at the same time, it is slowly metabolized. That is why azithromycin should be taken by the patient for only three days , and the effect lasts up to 4 days due to its slow metabolism. This feature reduces the negative impact on the gastrointestinal tract.
The disadvantage is that the substance remains in the body for too long in low concentrations. This point contributes to the development of resistance, since protein synthesis is no longer inhibited and the substance is still effective (insufficient concentration).
Azithromycin, 3 pcs., 500 mg, film-coated tablets
Most of the observed adverse reactions are reversible after completion of the course of treatment or discontinuation of the drug.
Classification of the frequency of side effects (WHO): very often (with a frequency of more than 1/10), often (with a frequency of at least 1/100, but less than 1/10), infrequently (with a frequency of at least 1/1000, but less than 1 /100), rare (with a frequency of at least 1/10,000, but less than 1/1000), very rare (with a frequency of less than 1/10,000), including individual messages.
From the circulatory and lymphatic systems: often - lymphocytopenia, eosinophilia; uncommon - leukopenia, neutropenia; rarely - thrombocytopenia, hemolytic anemia.
From the central nervous system: often - dizziness, headache, paresthesia, impaired perception of taste, anorexia; infrequently - anxiety, nervousness, hyposthesia, insomnia, drowsiness; rarely - agitation, delirium, hallucinations; very rarely - fainting, convulsions, psychomotor hyperactivity, aggression, anosmia, loss of taste, parosmia, exacerbation of myasthenia gravis, perversion of smell.
From the senses: infrequently - hearing impairment, vertigo, visual impairment; unknown frequency - hearing impairment, including deafness and/or tinnitus.
From the respiratory system and JIOP organs: infrequently - shortness of breath, nosebleeds.
From the cardiovascular system: infrequently - a feeling of palpitations, “flushes” of blood to the face; very rarely - decreased blood pressure, arrhythmia, ventricular tachycardia, increased QT interval, arrhythmia.
Infectious diseases: infrequently - rhinitis, respiratory diseases, pharyngitis, pneumonia, candidiasis, including the mucous membrane of the oral cavity and genitals, gastroenteritis.
From the digestive system: very often - nausea, diarrhea, abdominal pain, flatulence (bloating), often - vomiting; uncommon - belching, dysphagia, gastritis, constipation, dryness of the oral mucosa, ulcers of the oral mucosa, increased secretion of the salivary glands; very rarely - discoloration of the tongue, pseudomembranous colitis, pancreatitis.
From the liver and biliary tract: infrequently - hepatitis, hyperbilirubinemia, increased activity of “liver” transaminases; very rarely - cholestatic jaundice, liver failure (in rare cases, fatal, mainly due to liver dysfunction), fulminant hepatitis, liver necrosis.
Allergic reactions: often - itching, rash; uncommon - Stevens-Johnson syndrome, photosensitivity, urticaria; rarely - anaphylactic reactions (including angioedema) in rare cases with fatal outcome, toxic epidermal necrolysis. erythema multiforme.
From the skin and subcutaneous tissues: dry skin, dermatitis, sweating.
From the musculoskeletal system: often - arthralgia; uncommon - osteoarthritis, myalgia, neck pain, back pain.
From the genitourinary system: infrequently - increased residual urea nitrogen and creatinine concentration in the blood plasma, dysuria, pain in the kidneys, metrorrhagia. testicular dysfunction; very rarely - interstitial nephritis, acute renal failure.
Other: often - weakness; uncommon - chest pain, peripheral edema, asthenia (malaise, feeling tired); Uncommon: facial swelling, fever.
Laboratory data: often - an increase in the number of basophils, monocytes, neutrophils, a decrease in the concentration of bicarbonates in the blood plasma; infrequently - increased alkaline phosphatase activity, increased chlorine content, increased glucose concentration, increased bicarbonate concentration in the blood plasma, increased platelet count, increased hematocrit, change in sodium content in the blood plasma, change in the concentration of potassium in the blood plasma.
Any side effect should be reported to your doctor.
Side effects and contraindications
- Common side effects (less than 10% of patients): gastrointestinal disorders such as anorexia, nausea, vomiting, diarrhea, soft stools, abdominal pain, abdominal cramps, indigestion and constipation.
- Rare side effects (less than 1% of patients): flatulence, taste disturbances, fungal infections, vaginal thrush, allergic reactions such as skin rashes, itching and urticaria, nervousness, dizziness, drowsiness, headaches, paresthesia and fatigue.
- Very rare side effects (less than 0.1% of patients): colic, seizures, hyperactivity, aggression, malaise, general weakness, anxiety, rage, low blood pressure, palpitations, arrhythmias, severe persistent diarrhea, photosensitivity reactions (skin reactions to sunlight), joint pain, discoloration of the tongue. Serious allergic reactions are very rare.
Azithromycin therapy may lead to an increase in transaminases.
Azithromycin is contraindicated in severe liver failure . Another important contraindication is allergic reactions to azithromycin or other macrolide antibiotics.
Cardiovascular risk and azithromycin
An American study found that taking azithromycin for five days slightly increased the risk of cardiac death. Additional cardiovascular death was reported in 1:21,000 patients, especially in people who had a history of cardiovascular disease.
A further large Danish population-based cohort study, which was conducted in patients under 65 years of age, showed that there was no increased risk of mortality. So treatment with azithromycin in young people with cardiovascular disease is not associated with an increase in cardiovascular risk.
AZITHROMYCIN 500MG N3 FILM COATED TAB
If a dose is missed, the missed dose should be taken as soon as possible and subsequent doses should be taken 24 hours apart. The drug should be taken 1 hour before or 2 hours after taking antacid medications.
Use with caution in patients with mild to moderate hepatic impairment due to the possibility of developing fulminant hepatitis and severe hepatic impairment in such patients. If there are symptoms of liver dysfunction (rapidly increasing asthenia, jaundice, darkening of urine, tendency to bleeding, hepatic encephalopathy), azithromycin therapy should be discontinued and a study of the functional state of the liver should be performed.
In case of impaired renal function: in patients with GFR 10–80 ml/min, no dose adjustment is required; therapy with Azithromycin should be carried out with caution under monitoring the state of renal function.
There is no data on a possible interaction between azithromycin and ergotamine and dihydroergotamine derivatives, but due to the development of ergotism with the simultaneous use of macrolides with ergotamine and dihydroergotamine derivatives, this combination is not recommended.
With long-term use of azithromycin, the development of pseudomembranous colitis caused by Clostridium difficile
, both in the form of mild diarrhea and severe colitis. If antibiotic-associated diarrhea develops while taking azithromycin, as well as 2 months after the end of therapy, clostridial pseudomembranous colitis should be excluded.
Do not use medications that inhibit intestinal motility.
The drug should not be used in longer courses than indicated in the instructions, since the pharmacokinetic properties of azithromycin allow us to recommend a short and simple dosage regimen.
As with the use of other antibacterial drugs, during therapy with azithromycin, patients should be regularly examined for the presence of non-susceptible microorganisms and signs of superinfection, including fungal infection.
When treated with macrolides, including azithromycin, prolongation of cardiac repolarization and QT interval was observed, increasing the risk of developing cardiac arrhythmias, including arrhythmias. Caution should be exercised when using azithromycin in patients with the presence of proarrhythmogenic factors (especially in elderly patients, including those with congenital or acquired prolongation of the QT interval; in patients taking antiarrhythmic drugs of classes IA (quinidine, procainamide), III (dofetilide, amiodarone and sotalol ), cisapride, terfenadine, antipsychotics (pimozide), antidepressants (citalopram), fluoroquinolones (moxifloxacin and levofloxacin), in patients with fluid and electrolyte imbalance, especially in the case of hypokalemia or hypomagnesemia, clinically significant bradycardia, cardiac arrhythmia or severe heart failure .
When using azithromycin, myasthenic syndrome or exacerbation of myasthenia may develop.
Impact on the ability to drive vehicles and machinery
During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions. If undesirable effects develop on the nervous system (dizziness, drowsiness, fainting, convulsions) and the organ of vision (impaired clarity of visual perception), you should refrain from performing these types of activities.
Azithromycin recipe in Latin
A prescription for azithromycin in Latin is written depending on its dosage form and according to generally accepted rules for writing a prescription in Latin. Azithromycin is available in the following forms:
Capsules (250 mg) - more details about the recipe for capsules in Latin.
Rp.: Azithromycini 250 mg Dtd N 6 in caps. S. Orally, 1 capsule 2 times a day.
Tablets (125, 500 mg) - more details about the recipe for tablets in Latin.
Rp.: Azithromycini 500 mg Dtd N 3 in tab. S. Orally, 1 tablet 1 time per day.
Syrup (100 or 200 mg/5ml) - syrup recipe in Latin.
Rp.: Sir. Azithromycini 200/5 mg DS Orally, 1 tablespoon 2 times a day.
500 mg bottles - bottle recipe in Latin and powder recipe in Latin.
Rp.: Pulv. Azithromycini 500 mg Dtd N 3 S. Intramuscularly 500 mg 1 time per day.
