What is the dosage and duration of azithromycin? Which patients are disabled? How to use it in children's patients?

Community-acquired pneumonia (CAP) is a common respiratory disease with a high incidence, especially in recent years, the aging of society and the transformation of people's living environment and lifestyle, so that the probability of CAP occurrence has also shown a significant upward trend, posing a serious threat to the health of our people [1].

In the treatment of CAP, azithromycin is one of the commonly used drugs, which belongs to the antibiotics of macrolides, which can play a certain effect in the treatment of Mycoplasma pneumoniae infection, and has a wide antibacterial spectrum, which has a certain effect on chlamydia, gram-negative positive bacteria, etc.
[2].

What is the dosage and duration of azithromycin? Which patients are disabled? How to use it in children's patients? Follow the small medicine of the world, let's take a look at it ~

Dosage and course of treatment

▌ Community-acquired pneumonia

Dosage

Injection: When this product is used to treat community-acquired pneumonia caused by specific pathogens, the recommended dose is 500mg per day, a single intravenous administration, at least 2 days
.
Intravenous administration is followed by oral treatment with azithromycin, 500 mg (i.
e.
, 250 mg tablets) once a day, and the total course of intravenous and oral therapy is 7-10 days
.
The timing of switching from intravenous to oral administration should be judged by clinical efficacy [3].

Tablets: upper and lower respiratory tract infections, and skin and soft tissue infections (except erythema migrans): 1500 mg total for 3 days (500 mg per day) [4].

Dispersible tablets: This product is a dispersible tablet, which can be directly taken / swallowed, or the product is put into 100ml of water in an appropriate amount, shaken and dispersed, and taken
1 hour before or 2 hours after a meal.
Treatment of other infections: 0.
5 g (2 tablets) on day 1, 0.
25 g (1 tablet) per day on days 2 to 5, or 0.
5 g (2 tablets) daily for 3 days [5].

Capsules: 0.
5 g on day 1, 0.
25 g per day on days 2 to 5, or 0.
5 g daily for 3 days [6-7].

Which patients are disabled?

It is contraindicated
in patients known to be allergic to azithromycin, erythromycin, and other macrolides or ketolactones.
Contraindicated
in patients with a history of cholestatic jaundice/hepatic insufficiency after previous use of azithromycin.

Hepatotoxicity: there have been reports of abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and liver failure, some of which may be fatal
.
If symptoms and signs of hepatitis appear, the use of this product
should be discontinued immediately.

QT interval prolongation: it has been reported that the use of other macrolide antibiotics, including azithromycin, can cause ventricular repolarization and QT interval prolongation, resulting in the risk of
arrhythmias and torsades de pointes.
In post-marketing monitoring of patients taking azithromycin, there are spontaneous reports
of cases of torsades de pointes ventricular tachycardia.
High-risk groups include:

Patients
with known QT interval prolongation, torsades de pointes ventricular tachycardia, congenital QT prolongation syndrome, bradyarrhythmias, or decompensated heart failure.

Patients taking drugs known to prolong the QT interval, such as those treated with antipsychotics, antidepressants, and fluoroquinolones
.

Patients in an arrhythmia, such as uncorrected hypokalaemia or hypomagnesemia, clinically significant bradycardia, and patients
receiving antiarrhythmic drugs for type IA (quinidine, procainamide) and III (dofetilide, amiodarone, sotalol).

Older patients: older patients may be more sensitive to drug-related QT intervals [3-7].

How do children use it?

The efficacy and safety of injectable azithromycin in children and adolescents under 16 years of age have not been proven[3].

Azithromycin tablets 500 mg for children weighing more than 45 kg can be taken as recommended for adults [4].

Azithromycin tablets 500 mg are not suitable for children weighing less than 45 kg[4].

Dispersible tablets:

1.
For the treatment of otitis media and pneumonia, on the 1st day, take 10mg/kg according to body weight [the maximum amount of a day does not exceed 0.
5g (2 tablets)], and on the 2nd to 5th day, take 5mg/kg of body weight every day [the maximum amount of a day does not exceed 0.
25g (1 tablet)].

2.
For the treatment of pediatric pharyngitis and tonsillitis, take 12mg/kg of body weight a day [the maximum amount of a day is not more than 0.
5g (2 tablets)], and use for 5 days [5].