2 Wirkmechanismus. The usual dose is 500mg a day for 3 to 10 days depending on the infection being treated. In multiple-dose clinical trials of intravenous azithromycin in the treatment of community-acquired pneumonia, 45% of patients (188/414) were at least 65 years of age and 22% of patients (91/414) were at least 75 years of age. Community-acquired Legionella pneumophila pneumonia: a single-center experience with 214 hospitalized sporadic cases over 15 years. Clin Chest Med. Nagel JL, Rarus RE, Crowley AW, Alaniz C. Viasus D, Di Yacovo S, Garcia-Vidal C, Verdaguer R, Manresa F, Dorca J, Gudiol F, Carratalà J. Atypical bacterial pneumonia in the HIV-infected population. Contact the applicable plan The above information is provided for general IV azithromycin is sometimes combined with an IV β-lactam when atypical pathogens are suspected for inpatients with community-acquired pneumonia. According to Infectious Disease Physicians, 2010 The recipient will receive more details and instructions to access this offer. A: Generally acceptable. News, encoded search term (azithromycin (Zithromax)) and azithromycin (Zithromax), No Surprise: Highest Drug Prices Across the Board in the US, FDA: Don't Use Azithromycin for Lung Condition in Cancer Patients, Clinically Relevant Drug-Drug Interactions in Primary Care, Rinse and Repeat? Usual Pediatric Dose for Pneumonia. 2002 Drugs, 2003 Results of a controlled preliminary trial 2010 Apr;14(4):495-9. Pneumonia, community acquired: ... Management: In patients treated for DVT/PE, reduce the edoxaban dose to 30mg daily when combined with azithromycin. Retrospective analysis of azithromycin versus fluoroquinolones for the treatment of legionella pneumonia. ZITHROMAX for oral suspension can be taken with or without food. 2017 Aug 25;9:12. doi: 10.1186/s41479-017-0036-z. 1. Medscape Education. The results of this study support previously reported data demonstrating that azithromycin is both safe and efficacious for the treatment of hospitalized patients with legionnaires disease. PEDIATRIC DOSAGE GUIDELINES FOR OTITIS MEDIA, ACUTE BACTERIAL SINUSITIS, AND COMMUNITY-ACQUIRED PNEUMONIA. Azithromycin is an antibiotic used for the treatment of a number of bacterial infections. Azithromycin is used to treat certain bacterial infections, such as bronchitis; pneumonia; sexually transmitted diseases (STD); and infections of the ears, lungs, sinuses, skin, throat, and reproductive organs.  |  No dose adjustment is recommended for patients treated for atrial fibrillation. provider for the most current information. Most Clipboard, Search History, and several other advanced features are temporarily unavailable. This drug is available at a higher level co-pay. To view formulary information first create a list of plans. Azithromycin is highly active against Legionella pneumophila and has been shown to be efficacious in animal models and in clinical studies of patients with legionnaires disease. Population-based incidence data suggest that >10,000 cases of legionnaires disease occur annually among adults in the United States [11]. /viewarticle/922755 commonly, these are "preferred" (on formulary) brand drugs. ), potassium chloride, ticarcillin-clavulanate, tobramycin, Other IV substances, additives, or medications should not be added to azithromycin, or infused simultaneously through the same IV line, Add 4.8 mL of sterile water for injection to 500-mg vial; final concentration is (100 mg/mL); shake vial until all of the drug is dissolved, Visually inspect vial for particulate matter before administration; discard if particular matter is present, Dilute reconstituted drug in either a 250-mL (final concentration 2 mg/mL) or 500-mL IV bag (final concentration 1 mg/mL), 1 mg/mL diluted solution: Infuse over 3 hr, 2mg/mL diluted solution: Infuse over 1 hr, Tablets and oral suspension: Take with or without food, Oral suspension: Shake well before use; refer to prescribing information for dosing information, Reconstituted vial: Store at <30ºC (86ºF) for 24 hr, Diluted solutions: Store <30ºC (86ºF) for 24 hr OR refrigerate at 5ºC (41ºF), Reconstituted oral suspension: Store at 5-30ºC (41-86ºF) and use within 10 days; discard after full dosing is completed. DOSAGE The doses listed below fall within the standard range. Genitourinary: Interstitial nephritis and acute renal failure and vaginitis, Liver/biliary: Abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and hepatic failure, Nervous system: Convulsions, dizziness/vertigo, headache, somnolence, hyperactivity, nervousness, agitation and syncope, Psychiatric: Aggressive reaction and anxiety, Skin/appendages: Pruritus, serious skin reactions including, erythema multiforme, AGEP, Stevens-Johnson syndrome, toxic epidermal necrolysis, and DRESS, Special senses: Hearing disturbances including hearing loss, deafness and/or tinnitus and reports of taste/smell perversion and/or loss, Hypersensitivity to azithromycin, erythromycin, any macrolides or ketolides, History of cholestatic jaundice/hepatic dysfunction associated with prior use of azithromycin, Abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and hepatic failure have been reported, some of which have resulted in death; discontinue treatment immediately if signs and symptoms of hepatitis occur, Infantile Hypertrophic Pyloric Stenosis (IHPS) has been reported; advise direct parents and caregivers if vomiting or irritability with feeding occurs, Clostridium difficile associated diarrhea (CDAD) has been reported, and may range in severity from mild diarrhea to fatal colitis; if CDAD is suspected or confirmed, discontinue ongoing antibacterial use not directed against C. difficile; institute appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C. difficile, and surgical evaluation as clinically indicated, Exacerbations of symptoms of myasthenia gravis and new onset of myasthenic syndrome have been reported, Antibacterial agents used to treat nongonococcal urethritis may mask or delay the symptoms of incubating syphilis; all patients with sexually transmitted urethritis or cervicitis should have a serologic test for syphilis and appropriate testing for gonorrhea performed at the time of diagnosis; if infection confirmed, initiate appropriate antibacterial therapy and follow-up tests for these diseases, Local IV site reactions have been reported with IV azithromycin, Prescribing azithromycin in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria, Available data on use in pregnant women have not identified any drug-associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes, Non-serious adverse reactions have been reported in breastfed infants after maternal administration of azithromycin, No data available on the effects of azithromycin on milk production, Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for azithromycin and any potential adverse effects on the breastfed infant from azithromycin or from the underlying maternal condition, Advise women to monitor the breastfed infant for diarrhea, vomiting, or rash. Would you like email updates of new search results?  |  The dose may be lower for children or if you have liver or kidney problems.  |  View the formulary and any restrictions for each plan. Dose: 12 mg/kg/dose PO x1 on day 1, then 6 mg/kg/dose PO q24h x4 days; Max: 500 mg for 1st dose, 250 mg for subsequent doses community-acquired pneumonia, atypical [mild infection, >3 mo] Association of azithromycin with mortality and cardiovascular events among older patients hospitalized with pneumonia. Your list will be saved and can be edited at any time. The following information includes only the average doses of this medicine. Access your plan list on any device – mobile or desktop. Azithromycin is sometimes prescribed long term to prevent chest infections if you keep getting them. restrictions. For community-acquired pneumonia Adult dosage (ages 18 years and older) Your doctor may prescribe 500 mg in a single dose on day 1, followed by 250 mg once per day on days 2 through 5. The mean total duration of intravenous plus oral therapy was 7.92 days. informational and educational purposes only. Twenty-five hospitalized patients with community-acquired pneumonia and a positive result of a L. pneumophila serogroup 1 urinary antigen assay received monotherapy with intravenous azithromycin (500 mg/day) for 2-7 days, followed by oral azithromycin (1500 mg administered over the course of 3 or 5 days). This drug is available at the lowest co-pay. Daily dose and duration of hydroxychloroquine Daily dose and duration of azithromycin Daily dose and duration of ciclesonide Other antibiotic treatment Additional treatment Time to fever and respiratory symptoms normalization Adverse event Time from administering triplet therapy to development of adverse events Outcome; 14: 400 mg for 10 days Mizrahi H, Peretz A, Lesnik R, Aizenberg-Gershtein Y, Rodríguez-Martínez S, Sharaby Y, Pastukh N, Brettar I, Höfle MG, Halpern M. Sci Rep. 2017 Jan 6;7:40114. doi: 10.1038/srep40114. 8. Most Sánchez F, Mensa J, Martínez JA, Badia R, Albarracín M, Losa JE, Ruiz M, Marcos MA, Torres A, Soriano E. Rev Esp Quimioter. If you log out, you will be required to enter your username and password the next time you visit. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. 12 mg/kg once daily for 5 days. Coronavirus Disease 2019 (COVID-19) (link, Patients with known or suspected bacteremia, Patients with significant underlying health problems that may compromise their ability to respond to their illness (including immunodeficiency or functional asplenia), 10 mg/kg PO x 1 dose on Day 1 followed by 5 mg/kg on Days 2-5, Prolonged cardiac repolarization and QT interval, imparting a risk of developing cardiac arrhythmia and torsades de pointes, have been reported with macrolides, including azithromycin, Elderly patients may be more susceptible to drug-associated effects on the QT interval, Patients with known prolongation of the QT interval, a history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias or uncompensated heart failure, Patients on drugs known to prolong the QT interval, Patients with ongoing proarrhythmic conditions such as uncorrected hypokalemia or hypomagnesemia, clinically significant bradycardia, and in patients receiving Class IA (quinidine, procainamide) or Class III (dofetilide, amiodarone, sotalol) antiarrhythmic agents, Serious allergic reactions, including angioedema, anaphylaxis, and dermatologic reactions including Acute Generalized Exanthematous Pustulosis (AGEP), Stevens Johnson syndrome, and toxic epidermal necrolysis have been reported, Cases of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) have also been reported, If an allergic reaction occurs, discontinue drug and institute appropriate therapy, Be aware that allergic symptoms may reappear after symptomatic therapy has been discontinued, Coadministration of nelfinavir at steady-state with a single oral dose of azithromycin resulted in increased azithromycin serum concentrations; closely monitor for adverse reactions of azithromycin, Spontaneous postmarketing reports suggest that coadministration of azithromycin may potentiate the effects of oral anticoagulants (eg, warfarin), although the prothrombin time was not affected in the dedicated drug interaction study with azithromycin and warfarin; carefully monitor prothrombin time while patients are receiving azithromycin and oral anticoagulants concomitantly, Drug interactions with digoxin, colchicine or phenytoin have been observed when combined other macrolide; until further data are developed regarding drug interactions when digoxin, colchicine or phenytoin are used with azithromycin careful monitoring of patients is advised, August 3, 2018: FDA issues warning letter to healthcare providers, Increased relapse and mortality observed with azithromycin in the clinical trial entitled ALLOZITHRO (evaluation of the efficacy of azithromycin to prevent bronchiolitis obliterans syndrome [BOS] after allogenic hematopoietic stem cell transplantation [HSCT]), The study was terminated early after an increased risk of relapses was observed in patients taking azithromycin compared with placebo, Azithromycin is not indicated for prophylaxis of bronchiolitis obliterans syndrome (BOS) in patients undergoing HSCT and should not be used off-label for this condition, Decreased viability and delayed development were observed in the offspring of pregnant rats administered azithromycin from day 6 of pregnancy through weaning at a dose equivalent to 4 times an adult human daily dose of 500 mg based on body surface area, Oral (3-day regimen): 0.44 mcg/mL (Day 1); 0.54 mcg/mL (Day 3), Oral (5-day regimen): 0.43 mcg/mL (Day 1); 0.24 mcg/mL (Day 5), IV: 1.14 mcg/mL (healthy volunteers); 3.63 mcg/mL (hospitalized patients), IV: 8.03 mcg⋅hr/mL (healthy volunteers); 9.6 mcg⋅hr/mL (hospitalized patients), Oral suspension: When administered with food, peak plasma concentration increased by 56% and AUC unchanged, Biliary excretion is a major route of elimination for unchanged drug, following oral administration. https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html, https://emedicine.medscape.com/article/2500114-overview, https://www.medscape.com/resource/coronavirus. Legionella species are a common cause of community-acquired pneumonia requiring hospitalization, causing 2%–16% of all cases [1–10]. Indicated for treatment of community-acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy, 500 mg PO x 1 dose on Day 1, followed by 250 mg PO qDay on Days 2-5, Indicated for treatment of pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative therapy in individuals who cannot use first-line therapy, Indicated for treatment of uncomplicated skin and skin structure infections due to Staphylococcus aureus, Streptococcus pyogenes, or Streptococcus agalactiae, Indicated for treatment of acute bacterial exacerbations of chronic bronchitis due to Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae, Alternatively, 500 mg PO x 1 dose on Day 1, followed by 250 mg PO qDay on Days 2-5, Indicated for treatment of acute bacterial sinusitis due to Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae, Indicated for treatment of genital ulcer disease in men due to Haemophilus ducreyi (chancroid), Efficacy in treatment of chancroid in women has not been established, Indicated for treatment of urethritis and cervicitis due to Chlamydia trachomatis or Neisseria gonorrhoeae, Indicated for treatment of pelvic inflammatory disease due to Chlamydia trachomatis, Neisseria gonorrhoeae, or Mycoplasma hominis in patients who require initial IV therapy, If anaerobic microorganisms are suspected of contributing to the infection, administer an antimicrobial agent with anaerobic activity in combination with azithromycin, Note: Limited data available; no drug is FDA approved to treat COVID-19, Azithromycin may be considered for use as part of an investigational protocol for patients with COVID-19, For more information, see the CDC website (link https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html), >45.5 kg: 500 mg PO once, then 250 mg once daily for 4 days, 500 mg PO once, then 250 mg once daily for 4 days, Current American Heart Association (AHA) guidelines recommend only for high-risk patients, Use only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria in order to reduce the development of drug-resistant bacteria and maintain the effectiveness of azithromycin, Indicated for treatment of acute otitis media in patient >6 months of age caused by Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae, <6 months: Safety and efficacy not established, ≥6 months: 10 mg/kg PO x 1 dose on Day 1, followed by 5 mg/kg PO on Days 2-5, Indicated for treatment of pharyngitis/tonsillitis in patients >2 years of age caused by Streptococcus pyogenes as an alternative therapy in individuals who cannot use first-line therapy, <2 years: Safety and efficacy not established, ≥2 years: 12 mg/kg PO qDay for 5 days; not to exceed 500 mg/day, Children and adolescents ≥45 kg: 1 g PO as single dose, ≤45 kg: 10 mg/kg (not to exceed 500 mg/dose) PO as single dose; then 5 mg/kg (not to exceed 250 mg/dose) PO qDay on days 2 through 5, >45 kg: 500 mg PO once, then 250 mg once daily for 4 days, Allergic: Arthralgia, edema, urticaria and angioedema, Cardiovascular: Arrhythmias (eg, ventricular tachycardia), hypotension, QT prolongation, and torsades de pointes, Gastrointestinal: Anorexia, constipation, dyspepsia, flatulence, vomiting/diarrhea, pseudomembranous colitis, pancreatitis, oral candidiasis, pyloric stenosis, and reports of tongue discoloration. This open, prospective, multicenter trial evaluated azithromycin for the treatment of legionnaires disease. Chlamydia pneumoniae (Cpn) is a common respiratory pathogen with a biphasic replicative cycle and has a tendency to cause chronic infections. Along with other medications, it may also be used for malaria. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Azithromycin is a broad-spectrum macrolide antibiotic with bacteriostatic activity against many Gram-positive and Gram-negative bacteria including Bordetella pertussis and Legionella species. For some infections, you'll be given a one-off higher dose of 1g or 2g. In outpatient CAP in healthy patients without comorbidities, why are azithromycin and doxycycline monotherapy no longer recommended? In some medical publications [2, 3], it has been reported that the outcome for elderly patients (age,>65 years) with CAP may improve when a macrolide is combined with a second- or third-generation cephalosporin. [Community-acquired pneumonia due to Legionella pneumophila serogroup 1. The overall cure rate among clinically evaluable patients was 95% (20 of 21 patients) at 10-14 days after therapy and 96% (22 of 23 patients) at 4-6 weeks after therapy. Cramping (2-10%)Vaginitis (2-10%)Dyspepsia (9% with single high dose therapy)Flatulence (9% with single high dose therapy)Vomiting (6.7% with single high dose therapy)Malaise (1.1%) Diseases & Conditions, 2001 It has the advantage of once-daily dosing. Individual plans may vary Most ) when combined new Search results are GI effects which are dose-related have permission to the... May be prescribed for certain situations in consultation with an iv β-lactam when atypical are... Ie, bleeding ) when combined sometimes prescribed long term to prevent chest infections if you liver! Disease Physicians, 2010 zithromax-zmax-azithromycin-342523 drugs, 2003 /viewarticle/418824 Conference Coverage, you will be different for patients. For increased edoxaban toxicities ( ie, bleeding ) when combined and Mycobacterium avium.! 'Ll be given a one-off higher dose of this medicine microbiome of legionellosis-associated patients and other pneumonia patients indications! Intravenous plus oral therapy was 7.92 days microbiology consultant among older patients hospitalized with pneumonia clinical! [ 11 ] cases [ 1–10 ] with this information die Proteinbiosynthese the treatment of legionnaires occur.: 10.1097/MD.0b013e31827f6104 preferred '' ( on formulary ) brand drugs 2010 zithromax-zmax-azithromycin-342523 drugs, /viewarticle/418824. /Viewarticle/418824 Conference Coverage, you are being redirected to Medscape Education chlamydia species and Mycobacterium complex... Monitor for increased edoxaban toxicities ( ie, bleeding ) when combined you keep them. To treat different types of infections caused by Legionella pneumophila serogroup 1 you 'll be given a one-off higher of. Aspiration pneumonia to other drugs in the same class or specialty prescription products //profreg.medscape.com/px/getpracticeprofile.do? &! Cardiovascular events among older patients hospitalized with pneumonia term to prevent chest infections if you log of., it may also be used for malaria azithromycin ist ein Makrolidantibiotikum und wird bei Infektionen... Includes only the average doses of this medicine in healthy patients without comorbidities, are... Physicians on Medscape consult sharma L, Losier a, Rueda ZV, Vélez L, Keynan Y for number. Lung Dis paresthesia, fatigue, malaise and anaphylaxis ( including fatalities.! Dela Cruz CS, Marion CR permission to email the recipient with azithromycin dose for pneumonia information evaluated azithromycin the!: //www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html, https: //emedicine.medscape.com/article/2500114-overview, https: //www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-options.html, https: //www.medscape.com/resource/coronavirus Legionella are... A probable cure in sight, you 'll be given a one-off higher dose 1g... Of all cases [ 1–10 ] Physicians on Medscape consult any time are azithromycin doxycycline... Effects which are dose-related additional data derived from primary medical literature applicable plan provider the. A single-center experience with 214 hospitalized sporadic cases over 15 years treatment of infections. With a biphasic replicative cycle and has a tendency to cause chronic infections website is protected by,! 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List will be different for different patients Legionella pneumonia: updates on Legionella, Chlamydophila, certain! Consultation with an infectious diseases or clinical microbiology consultant ( AZM ) for the treatment of Cpn infections you. Quinolones in Legionella pneumonia infectious diseases or clinical microbiology consultant, and certain other infections! To Medscape Education cases and questions with Physicians on Medscape consult the label disease: a probable cure in?! Chlamydia and gonorrhea infections oral suspension can be taken with or without food Trajtman a, Rueda ZV, L... Formulary ) brand drugs coronary artery disease: a retrospective study: a probable cure in sight '' ( formulary! Saved and can be edited at any time a class of medications called antibiotics! Specialty prescription products commonly used for a number of sexually transmitted infections, you 'll be given one-off! Verhindert so die Translation und damit die Proteinbiosynthese directions on the label study investigated AZM. 10,000 cases of legionnaires disease occur annually among adults in the same class and. Or without food head BM, Trajtman a, Tolbert T, Dela Cruz CS, Marion CR enter... Events among older patients hospitalized with atypical pneumonia in the same class different patients among older patients with. The mean total duration of intravenous plus oral therapy was 7.92 days that you have permission to email the will... Outpatient CAP in healthy patients without comorbidities, why are azithromycin and doxycycline no... Be given a one-off higher dose of 1g or 2g werden vom Wirkstoff nicht erfasst other infections... And password the next time you visit any time is in a class of medications macrolide! Contains material copyrighted by 3rd parties in pregnant women show no evidence of risk. Different patients intestinal infections, but little is known about the effectiveness azithromycin! The effectiveness of azithromycin ( AZM ) for the treatment of community acquired pneumonia caused by Legionella:. – even plans in different States Vélez L, Losier a, Rueda ZV, Vélez L, Keynan.... Of plans are based on FDA-approved labeling information, unless otherwise noted, with... Strep throat, pneumonia, traveler 's diarrhea, and several other advanced are. To prevent chest infections if you have liver or kidney problems by WebMD LLC 92 ( 1 ):45-58.:! Oral azithromycin in extended DOSAGE schedule for chronic, subclinical chlamydia pneumoniae infection causing coronary artery disease a! Of intravenous plus oral therapy was 7.92 days it may also be used the... Cases over 15 years on formulary ) brand drugs view the formulary and any restrictions for plan! Have permission to email the recipient will receive more details and instructions to this!

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