Spectrum: Local Antimicrobial Stewardship, for Island Health

Azithromycin

C. diff Risk

Medium

Oral Bioavailability

Moderate

Approximate Cost

IV-$9/d PO-$1/d

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Adult

Respiratory Infection
500mg po/IV on day 1 then 250mg daily for 4 days
OR
500 mg IV/PO daily for 3 days

Chlamydia trachomatis
1g PO x 1 dose

Renal

General Information

Common Usage

Common Usage

  • Community acquired pneumonia

  • Pertussis

  • Upper respiratory tract infections

  • Chlamydial infections

  • Mycobacterial infections

  • Mycobacterium avium complex (MAC) prophylaxis in HIV patients

Drug Monitoring

Drug Monitoring

Monitor QTc in patients with increased risk

Adverse Effects

Adverse Effects

Prolongation of QTc interval - Association with increased cardiovascular mortality in observational studies.

Prolonged half life may contribute to macrolide resistance

May exacerbate muscle weakness in persons with myasthenia gravis. Use with caution.

Major Interactions

Major Interactions

  • Other drugs that prolong QTc

  • Increase INR with warfarin

  • Increases cyclosporine levels

  • May increase digoxin levels

  • Increased risk of rhabdomyolysis with statins

Additional Information

Additional Information

Very high tissue penetration and concentration intracellularly means in vivo activity may not be predicted by in vitro testing - i.e. Salmonella spp

Pharmacology

Pharmacology

Antimicrobial class: Macrolide

Pregnancy category: B

Average serum half life: 68.0

Biliary penetration: Therapeutic

CSF penetration: Poor

Lung penetration: Therapeutic

Urine penetration: Poor