بزرگسالان ۱۶ سال و بالاتر: ۵۰۰ میلیگرم به صورت تکدوز روز اول سپس از روز دوم ۲۵۰ میلیگرم دوبار هر 12ساعت 1کپسول در روز تا روز پنجم.
بزرگسالان ۱۶ سال و بالاتر: ۱۰۰۰ میلیگرم به صورت یک مقدار واحد.
عوارض جانبی احتمالی آزیترومایسین اسهال، دردهای شکمی، تهوع و استفراغ، زخمهای دهانی یا زبان، خارش یا ترشح واژن، پلاکهای سفید در دندان یا روی زبان، تب،خواب های پریشان، بی اشتهایی، افسردگی، حواس پرتی، درد مفصلی(آرترالژی) یا بثورات جلدی.
یک پاسخ حساسیتی نادر به آنتیبیوتیکها آنافیلاکسی است که نیازمند توجه و مراقبت فوری پزشکی میباشد. آنافیلاکسی به سرعت پیشرفت میکند و با علائمی چون تورم لبها و دور چشم، کهیر یا تورمهای پوستی، غش ناگهانی، ضربان قلب تند یا خسخس سینه یا مشکل در تنفس مشخص میشود.
داده های فارماکولژیک[ویرایش]
با مصرف اولین دوز ۵۰۰ میلی گرمی نیمهعمر دارو ۱۱ تا ۱۴ ساعت میباشد. نیمه عمر ۶۸ ساعت بعد از مصرف چند دوز متوالی بدست می آید (داروشناسی دیویس برای پرستاران). مدت اثر آزیترومایسین طولانی است. ۶۸ ساعت طول میکشد تا نیمی از دارو از بدن خارج شود.
پیوند به بیرون[ویرایش]
Azithromycin is an antibiotic useful for the treatment of a number of bacterial infections. This includes middle ear infections, strep throat, pneumonia, traveler's diarrhea, and certain other intestinal infections. It may also be used for a number of sexually transmitted infections including chlamydia and gonorrhea infections. Along with other medications, it may also be used for malaria. It can be taken by mouth or intravenously with doses once per day.
Common side effects include nausea, vomiting, diarrhea and upset stomach. An allergic reaction or a type of diarrhea caused by Clostridium difficile is possible. No harm has been found with its use during pregnancy. Its safety during breastfeeding is not confirmed, but it is likely safe. Azithromycin is an azalide, a type of macrolide antibiotic. It works by decreasing the production of protein, thus stopping bacterial growth.
Azithromycin was first made in 1980. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. It is available as a generic medication and is sold under many trade names worldwide. The wholesale cost in the developing world is about 0.18 to 2.98 USD per dose. In the United States it is about 33 USD for a course of treatment.
Azithromycin is used to treat many different infections, including:
Azithromycin has relatively broad but shallow antibacterial activity. It inhibits some Gram-positive bacteria, some Gram-negative bacteria, and many atypical bacteria.
A strain of gonnorhea reported to be highly resistant to azithromycin was found in the population in 2015. Neisseria gonorrhoeae is normally susceptible to azithromycin, but the drug is not widely used as monotherapy due to a low barrier to resistance development.
Aerobic and facultative Gram-positive microorganisms
Aerobic and facultative Gram-negative microorganisms
Pregnancy and breastfeeding
Safety of the medication during breastfeeding is unclear. It has been reported that because only low levels are found in breastmilk and the medication has also been used in young children, it is unlikely that breastfed infants would suffer adverse effects. Nevertheless, it is recommended that the drug be used with caution during breastfeeding.
Most common side effects are diarrhea (5%), nausea (3%), abdominal pain (3%), and vomiting. Fewer than 1% of people stop taking the drug due to side effects. Nervousness, dermatologic reactions, and anaphylaxis have been reported. As with all antimicrobial agents, pseudomembranous colitis can occur during and up to several weeks after azithromycin therapy. In the past, physicians cautioned women that antibiotics can reduce the effectiveness of oral contraceptives. However, antibiotics, with the exception of rifampin and rifabutin, do not affect the effectiveness of hormonal contraceptives. This change in advice comes because to date, no evidence conclusively demonstrates antibiotics (other than rifampicin or rifabutin) affect these contraceptives.
Occasionally, patients have developed cholestatic hepatitis or delirium. Accidental intravenous overdose in an infant caused severe heart block, resulting in residual encephalopathy. Clostridium difficile has been reported with use of azithromycin.
In 2013 the FDA issued a warning that azithromycin, "can cause abnormal changes in the electrical activity of the heart that may lead to a potentially fatal irregular heart rhythm." The FDA noted in the warning a 2012 study that found the drug may increase the risk of death, especially in those with heart problems, compared with those on other antibiotics such as amoxicillin or no antibiotic. The warning indicated people with preexisting conditions are at particular risk, such as those with QT interval prolongation, low blood levels of potassium or magnesium, a slower than normal heart rate, or those who use certain drugs to treat abnormal heart rhythms.
Mechanism of action
Azithromycin prevents bacteria from growing by interfering with their protein synthesis. It binds to the 50S subunit of the bacterial ribosome, thus inhibiting translation of mRNA. Nucleic acid synthesis is not affected.
Azithromycin is an acid-stable antibiotic, so it can be taken orally with no need of protection from gastric acids. It is readily absorbed, but absorption is greater on an empty stomach. Time to peak concentration (Tmax) in adults is 2.1 to 3.2 hours for oral dosage forms. Due to its high concentration in phagocytes, azithromycin is actively transported to the site of infection. During active phagocytosis, large concentrations are released. The concentration of azithromycin in the tissues can be over 50 times higher than in plasma due to ion trapping and its high lipid solubility. Azithromycin's half-life allows a large single dose to be administered and yet maintain bacteriostatic levels in the infected tissue for several days.
Following a single dose of 500 mg, the apparent terminal elimination half-life of azithromycin is 68 hours. Biliary excretion of azithromycin, predominantly unchanged, is a major route of elimination. Over the course of a week, about 6% of the administered dose appears as unchanged drug in urine.
A team of researchers at the pharmaceutical company Pliva—Gabrijela Kobrehel, Gorjana Radobolja-Lazarevski, and Zrinka Tamburašev, led by Dr. Slobodan Đokić—discovered azithromycin in 1980. It was patented in 1981. In 1986, Pliva and Pfizer signed a licensing agreement, which gave Pfizer exclusive rights for the sale of azithromycin in Western Europe and the United States. Pliva put its azithromycin on the market in Central and Eastern Europe under the brand name Sumamed in 1988. Pfizer launched azithromycin under Pliva's license in other markets under the brand name Zithromax in 1991.
Society and culture
In 2010, azithromycin was the most prescribed antibiotic for outpatients in the US, whereas in Sweden where outpatient antibiotic use is a third as prevalent, macrolides are only on 3% of prescriptions.