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Author: Admin | 2025-04-28
A maximum daily dose of 500 mg.Specific Patient PopulationsHepatic impairment: The pharmacokinetics of azithromycin in hepatic impairment have not been determined, so it should be prescribed cautiously in this population.Renal impairment: Azithromycin may be administered to patients with renal disease or failure without regard for creatinine clearance. Dose adjustments are usually not necessary.[37]Pregnancy considerations: According to the American College of Obstetricians and Gynecologists guidelines, azithromycin may be included in a combination regimen for managing preterm rupture of membranes and can serve as an adjunctive prophylactic antibiotic for patients undergoing emergent cesarean delivery. Additionally, azithromycin may be indicated in specific scenarios before vaginal delivery for patients at high risk of endocarditis.[40][41][42]Breastfeeding considerations: Azithromycin is concentrated minimally in breast milk, making adverse effects in breastfed infants unlikely; monitoring for gastrointestinal effects, including vomiting, diarrhea, and candidiasis, is recommended. One study demonstrated that a single dose of azithromycin administered to women who were nasal carriers of pathogenic Staphylococcus and Streptococcus during labor reduced bacterial counts in breast milk but increased the prevalence of azithromycin-resistant E coli and K pneumoniae. The use of azithromycin eye drops by breastfeeding mothers poses negligible risk to the infant, and applying pressure over the tear duct for 1 minute after administration can further reduce drug transfer to breast milk.[43]Pediatric patients: Azithromycin is indicated for patients 6 months or older with community-acquired pneumonia due to C pneumoniae, H influenzae, M pneumoniae, or S pneumoniae. Azithromycin is also FDA-approved for patients 6 months or older with acute otitis media caused by H influenzae, M catarrhalis, or S pneumoniae. Azithromycin is also indicated for patients 6 months or older with acute bacterial sinusitis caused by H influenzae, M catarrhalis, or S pneumoniae. For patients 2 years or older with pharyngitis or tonsillitis caused by S pyogenes, azithromycin is an alternative therapy for individuals who cannot tolerate first-line treatment.Older patients: No significant differences in safety or effectiveness have been observed between older and younger patients. However, greater sensitivity among some older patients cannot be ruled out based on reported clinical experiences. Adverse Effects Azithromycin is considered a safe antimicrobial agent, and only
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