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Zithromax is an antibiotic of a wide range of bacteriostatic effects. The principle of action of azithromycin is associated with the suppression of the protein of the microbial cell. In a high level of concentration creates a bactericidal effect.

Active Ingredient: Azithromycin

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What is Zithromax

Zithromax is an antibiotic of the azalide group with a wide variety of activities. Unlike macrolides, it acts less on gram-positive microorganisms, but shows significant activity against some gram-negative pathogens, in particular Acinetobacter, Pasteurella, significantly affects chlamydia, H. influenzae and M. catarrhalis.

Azithromycin is used for a wide range of diseases caused by sensitive microorganisms. 100% clinical and bacteriological effectiveness was noted for its use in patients with typhoid fever (500 mg once a day for 7 days). Given the significant toxicity of chloramphenicol, traditionally considered the choice of this disease, the high sensitivity of typhoid bacteria to azithromycin makes it one of the first to treat typhoid fever.

Effect on neutrophils. Many experimental and clinical studies have shown that macrolides, in particular azithromycin, are capable of exerting anti-inflammatory, immunomodulatory and mucoregulatory effects. These properties are associated with the modulating effect of macrolides on phagocytosis, chemotaxis, killing, and apoptosis of neutrophils. Under the influence of macrolides, the formation of highly active oxygen compounds, primarily NO, decreases, which can damage cells and tissues. By acting on the cellular component of the immune system, macrolides inhibit the synthesis and secretion of pro-inflammatory, enhancing the production of cytokines (interleukins 2, 4, 10). Zithromax, unlike some other macrolides, is already at an early stage able to suppress transendothelial migration of neutrophils, production of interleukin-8 and monocytes. There is also an additional indirect effect of azithromycin, manifested in slowing the migration of leukocytes due to the suppression of a special kinase that performs diapedesis. Zithromax has the highest degree of penetration into polymorphonuclear neutrophils and lingers much longer in them, which contributes to phagocytosis and anti-infection protection to a greater extent.

The high effectiveness of Zithromax in adults with respiratory tract infections such as tonsillopharyngitis, acute otitis media, sinusitis, has been proven by many controlled studies. Both in clinical efficacy, which is 93–100%, and in the degree of pathogen eradication (80–99%), azithromycin, prescribed once in a 3-day course at a dose of 500 mg / day, is not inferior to phenoxymethylpenicillin and other “new” macrolides – roxithromycin , clarithromycin, as well as oral cephalosporin cefaclor.

In patients with acute tonsillopharyngitis, Zithromax prescribes a more rapid disappearance of clinical symptoms and an improvement in general condition than with phenoxymethylpenicillin. A pharmacoeconomic analysis indicates the benefits of azithromycin used for tonsillopharyngitis for 3 days compared to a 10-day course of roxithromycin in terms of the cost-effectiveness criterion.

The use of Zithromax in infections of the respiratory tract, such as bronchitis and pneumonia, is based, firstly, on its ability to create high and long-lasting concentrations in bronchial secretions, bronchial mucosa, lung tissue and fluid lining the alveolar epithelium, and secondly, on high antibiotic activity against both classical (pneumoniae, influenzae, catarrhalis) and atypical respiratory pathogens (Chlamydia spp, M. pneumoniae, Legionella spp, C. burnetii).

The high efficacy of Zithromax in patients with respiratory tract infections is confirmed by the results of numerous controlled clinical trials, and no significant difference was found when comparing azithromycin with other macrolides, oral penicillins and cephalosporins. Azithromycin, prescribed mainly for 3 (and less frequently within 5) days for bronchitis and pneumonia, is not inferior to erythromycin, clarithromycin, roxithromycin, amoxicillin in clinical (82–98%) or bacteriological (52–100%) efficacy. co-amoxiclav and cefaclor, the duration of use of which for these infections is 7-10 days. When using azithromycin, faster normalization of body temperature, the disappearance of leukocytosis and subjective improvement were noted. Among the pathogens that were identified in the patients included in these studies, pneumoniae, influenzae, and catarrhalis predominated. In addition, mycoplasmas, chlamydia and legionella were found.

In an incomparable study, Zithromax was 100% effective in patients with legionellosis.

Despite the high effectiveness of azithromycin in people with pneumonia, caution should be exercised in its empirical use in severe forms, since pneumoniae caused by pneumoniae can be accompanied by bacteremia in 20-30% of cases. An injectable dosage form of azithromycin, which allows for the creation of high plasma concentrations, seems promising for such situations. In severe pneumonia requiring hospitalization, it is recommended that the antibiotic be administered intravenously at a dose of 500 mg / day for at least 2 days, followed by oral administration in the same dose until the general course of 7-10 days. As the first controlled studies showed, the clinical efficacy of azithromycin with this dosing regimen is 83–90%.

With prolonged (for 3 months) use of azithromycin at a dose of 250 mg per week in patients with diffuse panbronchiolitis caused by aeruginosa, its effectiveness is 84.6%.

Zithromax is the first representative of 15-membered macrolide-like antibiotics to form a subclass of azalides. The drug is most effective in people with respiratory infections. Azithromycin has the following advantages over erythromycin:
– acts better on gram-negative flora, especially influenzae;
– acts on avium;
– not destroyed in an acidic environment;
– creates significantly higher and stable concentrations in tissues;
– has a long half-life, which makes it possible to take the drug once a day;
– less likely to cause unwanted reactions and drug interactions.

The use of Zithromax can significantly simplify the treatment of infections, improve compliance and thereby increase the effectiveness of antibiotic therapy.

Zithromax Dosage

The tablets are taken orally intact. It is forbidden to bite and chew them. Multiplicity of intake – 1 times a day 2 hours before a meal.

– for adult patients and children from 12 years of age: take 0.5 g per day.
– the duration of use is 3 days.
– diseases of the genitourinary system: a single dose of 1 g.
– Lyme disease: the first time is 1000 mg, from the second to the fifth day, take 0.5 g.

Zithromax side effects

The antibiotic is well tolerated, the probability of a negative reaction of the body is low, but possible:
1. Gastrointestinal tract: bouts of nausea, less often vomiting, bloating, development of colitis of the pseudomembranous type. Very rarely: inflammatory diseases and liver necrosis.
2. Allergy: skin rash. Rarely: anaphylactic reactions, angioedema, hypersensitivity to ultraviolet rays.
3. Central nervous system: dizziness, prolonged headaches, distortion of taste. Rarely: drowsiness, emotional overexcitation, anxiety.
4. Heart and vascular system: arrhythmia, pain in the chest, tachycardia.
5. Urinary system organs: nephritis, vaginitis, candidiasis.
6. Musculoskeletal system: rarely aches and muscle pain.


Zithromax is not allowed if:
– individual intolerance to azithromycin;
– cases of an allergic reaction to other antibiotics from the macrolide group;
– serious kidney and liver problems.
Relative contraindications requiring careful admission:
– diseases of the kidneys and liver of mild or moderate severity;
– arrhythmia or predisposition to it.
Age limit – children not older than 12 years old or with a body weight of up to forty-four kilograms.

Zithromax overdose

It is observed with a systematic excess of the recommended dosages. Clinical picture: nausea and vomiting, diarrhea, hearing loss. There is no specific antidote. Overdose therapy is symptomatic. A gastric lavage is carried out, drugs from the group of antacids with aluminum and magnesium are prescribed.