Azitgro%20%28azithromycin%29

# Azitgro (azithromycin) ## Overview - Macrolide antibiotic with bacteriostatic activity against a broad range of gram-positive, gram-negative, and atypical pathogens. - Long half-life (~68 hours) allows once-daily dosing and short treatment courses. ## Primary Indications - Community-acquired pneumonia (CAP), acute bacterial sinusitis, pharyngitis/tonsillitis (Streptococcus pyogenes), acute otitis media, uncomplicated skin infections, urethritis/cervicitis (C. trachomatis), and MAC prophylaxis in advanced HIV. ## Adult Dosing - **CAP/sinusitis/pharyngitis:** 500 mg PO on day 1, then 250 mg PO days 2–5. - **Uncomplicated chlamydial infection:** 1 g PO single dose. - **MAC prophylaxis:** 1,200 mg PO once weekly (alone or with rifabutin). ## Pediatric Dosing - **≥6 months:** 10 mg/kg (max 500 mg) PO on day 1, then 5 mg/kg (max 250 mg) PO days 2–5. - **Otitis media** (≥6 months): alternative single-dose regimen: 30 mg/kg (max 1,500 mg) PO once. *Check local protocol for weight-based limits.* ## Dose Adjustments - **Renal:** No adjustment for mild–moderate impairment; use caution with CrCl <10 mL/min. - **Hepatic:** No adjustment for mild–moderate disease; avoid in severe hepatic impairment. ## Contraindications - Hypersensitivity to azithromycin, erythromycin, or any macrolide. - History of cholestatic jaundice/hepatic dysfunction with prior azithromycin use. - Concomitant use with disopyramide (risk of QT prolongation). ## Adverse Effects - **Common:** Diarrhea (including C. difficile), nausea, abdominal pain, vomiting, headache. - **Serious:** QT prolongation, torsades de pointes (especially with electrolyte disturbances/bradycardia), hepatotoxicity, severe skin reactions (SJS/TEN), myasthenia gravis exacerbation. ## Key Drug Interactions - **QT-prolonging drugs** (e.g., fluoroquinolones, class IA/III antiarrhythmics, methadone) – additive risk. - **Warfarin** – enhanced anticoagulation; monitor INR. - **Cyclosporine, rifabutin, digoxin** – increased levels; monitor. - **Antacids** (aluminum/magnesium) – reduce absorption; separate azithromycin by ≥2 hours. ## Monitoring - Baseline and periodic electrolytes, hepatic function (LFTs) with prolonged therapy. - ECG if risk factors for QT prolongation (monitor QTc interval). - Signs of superinfection or C. difficile diarrhea. ## Clinical Pearls - Administer on empty stomach (1 hour before or 2 hours after meals) to maximize absorption. - IV to oral conversion: IV bioequivalence is ~100% (use same oral dose schedule). - Discontinue if rash, jaundice, or arrhythmia symptoms occur. - Not first-line for CAP in Japan or other regions with high macrolide resistance. *Disclaimer: This information is educational and should not replace current prescribing guidelines. Always verify dosing, interactions, and contraindications with an up-to-date drug reference and local protocols before use.*