At present macrolides are included into one of the most unique and promising classes of antibiotics. First of all, they are distinguished from other antibacterial agents by good treating properties: they are able to penetrate into the cells of infected tissues and organs, create and maintain high concentrations in the pocket of infection for a long time, thereby affecting some gram-positive cocci resistant to penicillins, among other things. Actually if we compare to other similar preparations this has a really wide range of action.
The clinical studies of this medications group evidenced a great advantage over other antibacterial agents, which is also a good safety profile: macrolides are considered to be one of the safest classes of antibacterial agents – they have practically no toxic effect on the organs and tissues and less often cause allergic reactions. In addition to the antimicrobial effect, macrolides have anti-inflammatory, immunomodulatory and mucoregulating effects.
The most widely used macrolide of the new generation is the representative of the azalide group – Zithromax (active ingredient is Azithromycin), activity against bacteria of which is associated with its unique 15-member chemical structure. Azalides differ from other macrolides by the presence of a nitrogen atom in the lactone ring, which made them more active against gram-negative bacteria compared to erythromycin.
It is based on blocking the production of essential human protein in bacteria. It is active against following bacteria:
- hemophilus sticks;
- helicobacter pylori;
Zithromax is not used in the treatment of viral infections, other preparations have to be employed for that purpose.
One of the main contraindications is hypersensitivity to azithromycin and other macrolide antibiotics. In addition, azithromycin should be prescribed with caution to patients suffering from severe and moderate liver failure, severe and moderate degree of liver dysfunction. Also, please, note that it is contraindicated in children under three years and children whose body weight does not exceed 45 kg.
Also while administering Zithromax one should refrain from using medications belonging to the alpha-adrenoreceptor group.
This pharmaceutical product should be prescribed with caution in case of such diagnoses as myasthenia gravis; diseases which are treated with antipsychotic drugs, antidepressants, fluoroquinolones. Such disorders as water and electrolyte imbalance, especially if the patient suffers from kaliopenia or hypomagnesemia, heart arrhythmia, clinically significant bradycardia or severe heart failure are also considered as contraindications to taking this drug.
- These medications can be used during pregnancy and breastfeeding only if the intended benefit to the mother outweighs the potential risk to the fetus and child.
- It is recommended to suspend breastfeeding if there is a need to the use azithromycin.
- When taking azithromycin, avoid direct sunlight and ultraviolet radiation from tanning beds, as this can cause sunburn. The drug increases the sensitivity of the skin to ultraviolet light. To avoid sunburn you should use special sunscreen.
- The dosage regimen should be set individually, taking into account the clinical entity, the severity of the disease and the pathogen sensitivity.
- Adults are usually prescribed to administer this medicine inside in the amount of 0.25-1 g 1 time/day; children – 5-10 mg/kg once a day.
- This medicine has to be taken 1 hour prior or 2 hours after a meal, without chewing. Duration of treatment course is 2-5 days. In some cases the treatment course can be prolonged to 7 days, depending on disease severity.
- The recommended doses are designed for adults and children with body weight exceeding 45 kg.
- For the treatment of elderly patients over 65, the same doses are used as for adults, i.e. dose adjustment is not required. Taking into account that among elderly patients there may be people suffering from arrhythmogenic factors, it is necessary to keep in mind and pay special attention to the possibility of developing in them cardiac arrhythmias and ventricular tachycardia.
- In case of impaired renal function, as well as moderate liver impairment, dose adjustment is not required.
- Experience with the use of azithromycin in patients older than 75 years is limited.
HOW TO TAKE Zithromax?
- Take this drug with water, this rule is extremely important to observe, otherwise it might effect badly the mucous membrane of your stomach and interfere with the active substance’s absorption.
- You must never use a double dose of medication in case of missing the time of medicine admission. In this case it is enough to take the missed dosage as early as possible, but the next should be taken at intervals of 24 hours.
- In case of improper medications use the diarrhea may develop as a result of a new infection. If diarrhea is too watery and with blood you should immediately see a doctor. In order to avoid complications do not self-medicate.
SIDE EFFECTS Zithromax
- Zithromax, like many other medicines, has side effects that can result in a lack of appetite; skin rashes and irritations; headache; violation of taste sensations; dizziness; blurred vision; joints pain; weakness; temporary hearing loss.
- In addition, among the specific and common side effects there are difficulty breathing, swelling of the tongue, face and lips.
- Long-term or uncontrolled intake of Zithromax usually results in oral or vaginal infection. You should immediately contact your doctor if you find such changes as: the formation of white plaques on the oral mucosa, as well as change in color and consistency of vaginal discharge. Such symptoms are grounds for immediate discontinuation of the drug.
- At the same time it ought to be said that the manifestation of most side effects disappear after the end of the course of treatment or discontinuation of the drug.
- However, any side effect must be reported to your doctor.
- An overdose of the medicine is manifested by vomiting, diarrhea, temporary absence of hearing and abdominal pain. In this case, it is recommended to carry out an urgent symptomatic treatment, namely: flush the stomach and drink activated charcoal.
- If the symptoms of overdose persist for more than two hours, you should seek for a professional medical assistance.
Such drugs as antacids (aluminum and magnesium), as well as ethanol, reduce the concentration of the agent in the blood. Therefore, while taking antacids and azithromycin, it is necessary to observe an interval of 2 hours between taking these medications.
Tetracyclines and chloramphenicol, when taken together with Zithromax, enhance its effect. The drug increases the concentration of digoxin, and is also incompatible with heparin.
It is not recommended to combine Zithromax with other antibiotics or medications. Also, do not combine the intake of this medication with too fatty foods, as this can seriously affect the rate of its absorption and distribution.
- Simultaneous intake of azithromycin and alcohol is extremely undesirable, since the reaction of the body may be different.
- Alcohol reduces the absorption of the medicine in the body, which leads to a decrease of the agent accumulation in the pocket of infection and prolongation of treatment with an increase in the dose of the azithromycin or replacement with stronger antibiotics.
- In addition, the simultaneous use of azithromycin with alcohol can lead to transformation of the disease into chronic.
- Most doctors claim that alcohol is not compatible with antibiotics. There are no harmless drugs: positively affecting one organ, they also have a negative effect on another. And alcohol intake provokes the health condition deterioration, especially if the patient suffers from chronic diseases. Even an allergic reaction to alcohol may be observed.
- Therefore, while treatment course with Zithromax one should refrain from alcohol, heavy and unhealthy foods, smoking.
Below you can find feedbacks and comments of patients and physicians regarding the discussed agent.
Alex (surgeon): From my point of view it is rather good antibiotic when used in the treatment of inflammatory processes of lungs, soft tissues and bone tissue. I use it in my surgical practice and it did very well – it is effective against a wide range of microflora, there are few side effects, it is well tolerated by patients. I will recommend it to my colleagues and patients.
Sergio (dentist): It is good, time-proved agent. I use it in my dental practice against bacterial infections: periodontitis, dental periostitis. In case of such infections I usually prescribe 500 mg once a day during 3 days together with non-steroidal anti-inflammatory and antihistamine medications.
Andrew: I got sick with bronchitis, and my physician prescribed that agent for me. I took it at 500 mg once a day during the first three days. Then the dosage was reduced, as recommended by my therapist. I felt relief on the second day. I think this is a very good medication at an affordable price.
Clara: I was treated against pneumonia. Positive changes came very quickly, but by the end of the treatment course I had candidiasis in my mouth. The doctor said that this is due to the fact that my immunity is weakened.
Sarah: My son has otitis media. Initially he was prescribed medication, which did not help. The pain in the ear increased on the third day. And then the doctor recommended taking Zithromax. I doubted, since the child weighs 45 kg. But the doctor said to reduce the daily dose and on the second day already the severe pain in the ear practically disappeared.
Tom: I got sick just before the holidays. I had a fever and a strong cough. I went to the doctor and I was prescribed this medicine. I took a course of 5 days at 500 mg per day and completely recovered. I had no side effects. Great drug!