Macrolide類抗生素

Chancroid: Treatment of genital ulcer disease (in men) due to Haemophilus ducreyi
Chronic obstructive pulmonary disease(COPD), acute exacerbation: Acute bacterial exacerbations of COPD due to H. influenzae, M. catarrhalis, or S. pneumoniae
Mycobacterium avium complex(MAC): Prevention of MAC in patients with advanced HIV infection; treatment of disseminated MAC (in combination with ethambutol) in patients with advanced HIV infection
Otitis media, acute: due to H. influenzae, M. catarrhalis, or S. pneumoniae
Pneumonia, community-acquired: CAP due to Chlamydophila pneumoniae, H. influenzae, Legionella pneumophila, M. catarrhalis, Mycoplasma pneumoniae, or S. pneumoniae
Skin and skin structure infection, uncomplicated:due to S. aureus, S. pyogenes, or S. agalactiae
Streptococcal pharyngitis, group A: Treatment of pharyngitis/tonsillitis due to S. pyogenes as an alternative to first-line therapy
Urethritis/cervicitis: due to Chlamydia trachomatis or N. gonorrhoeae Note: CDC treatment guidelines for gonococcal infections only recommend azithromycin (in combination with gentamicin) for uncomplicated gonococcal infection of the cervix or urethra in patients who have a cephalosporin allergy

Antibiotic, Macrolide

1. Hypersensitivity to azithromycin or other macrolide antibiotics
2. Caution in patients with impaired liver function

B; Azithromycin crosses the placenta
Recommended for the treatment of several infections, including chlamydia, gonococcal infections, and Mycobacterium avium complex, and in certain situations prior to vaginal delivery in females at high risk for endocarditis

1. Decreased appetite, diarrhea, rash, and somnolence have been reported; monitor infants for GI disturbances.
2. According to the manufacturer, the decision to breastfeed during therapy should consider the risk and the benefits.

Abdominal pain, diarrhea, and nausea occur in high dose

Chronic obstructive pulmonary disease, acute exacerbation:
500 mg in a single loading dose on day 1, followed by 250 mg once daily on days 2 to 5 or 500 mg once daily for 3 days
Mycobacterium avium complex (MAC) infection:
500 to 600 mg daily as part of a combination therapy regimen
Pneumonia, community acquired:
500 mg on day 1, followed by 250 mg once daily for 4 days or 500 mg once daily for 3 days
Sexually transmitted infections:
1. Chancroid (due to Haemophilus ducreyi): 1 g as a single dose
2. Urethral infection, empiric therapy for urethritis or pathogen-directed therapy for Chlamydia trachomatis: 1 g as a single dose, preferably under direct observation or 500 mg on day 1 then 250 mg once daily for 4 days; give in combination with ceftriaxone if there is microscopic evidence of gonococcal infection
Streptococcus, group A infection (Pharyngitis):
12 mg/kg (maximum: 500 mg) on day 1, followed by 6 mg/kg (maximum: 250 mg) once daily on days 2 through 5 or 12 mg/kg (maximum: 500 mg) once daily for 5 days

General dosing:
5 to 12 mg/kg/dose; typically administered as 10 to 12 mg/kg/dose on day 1 (usual maximum dose: 500 mg/dose) followed by 5 to 6 mg/kg once daily (usual maximum dose: 250 mg/dose)

1. Mild to severe impairment: No dosage adjustment necessary
2. Hemodialysis: No dosage adjustment or supplemental dose necessary
3. Peritoneal dialysis: Minimally dialyzed; No dosage adjustment or supplemental dose necessary
4. CRRT: No dosage adjustment or supplemental dose necessary

Azithromycin is predominantly hepatically eliminated; however, there is no dosage adjustment provided in the manufacturer's labeling.