Azithromycin

Azithromycin is a special kind of medicine called an antibiotic that helps doctors treat many different bacterial infections. Some of these infections include middle ear infections, strep throat, pneumonia, traveler's diarrhea, and certain intestinal infections. It can also be used together with other medicines to help prevent or treat malaria. People can take azithromycin by mouth, through a special tube into a vein, or as drops placed in the eye.

This medicine is sold under brand names like Zithromax for tablets and Azasite for eye drops. Common side effects can include feeling sick to the stomach, vomiting, or having loose stools. In rare cases, it can cause serious health problems, so it is important to use it only when a doctor says so. Azithromycin works by stopping bacteria from making important parts they need to grow, which helps the body fight off the infection.

Azithromycin was first discovered in Croatia in 1980 and was approved for use in 1988. It is listed as one of the most important medicines in the world by the World Health Organization's List of Essential Medicines. Because many people need this medicine, it is now made as a generic medication and is available in many countries under different brand names. In 2023, it was one of the most prescribed medicines in the United States, with over 10 million prescriptions given out.

Medical uses

Azithromycin is a helpful medicine used to treat many different infections. It can help with infections in the sinuses, ears, lungs, throat, and skin. It is also used to treat some stomach infections and infections passed through close contact. This medicine works well for children and adults alike.

Azithromycin can stop the growth of many types of bacteria, including some that are hard to treat with other medicines. It is often chosen when other medicines might not work as well or cause side effects. Doctors may also use it to help prevent worsening of breathing problems in people with long-term lung conditions. However, it is important to use this medicine only when a doctor says it is needed, as using it too often can make bacteria stronger and harder to treat.

Adverse effects

Azithromycin can sometimes cause problems like diarrhea, nausea, stomach pain, and vomiting. Very few people stop taking it because of these side effects. Rarely, people may feel nervous, have skin reactions, or have serious allergic responses. There have also been reports of a specific infection called Clostridioides difficile linked to using this medicine.

This medicine does not stop birth control from working, unlike some other antibiotics. In some cases, people have had liver problems or confusion. There have been rare reports of hearing loss. The US Food and Drug Administration warned that this medicine can change the heart’s electrical activity in ways that might lead to dangerous heart rhythms, especially in people with certain heart conditions or low levels of potassium or magnesium in their blood.

Interactions

Azithromycin should not be taken with colchicine because it can cause harmful effects like stomach problems, fever, muscle pain, and serious health issues.

Azithromycin belongs to a group of antibiotics called macrolides. Some macrolides can interfere with a liver enzyme called CYP3A4, which helps process many medicines in the body. When this enzyme is blocked, it can cause problems with other medicines. Azithromycin has less effect on this enzyme compared to other macrolides like erythromycin and clarithromycin. This means it is safer to use with medicines such as statins, which are used to lower cholesterol and could cause muscle problems if taken with stronger inhibitors of CYP3A4.

Pharmacology

Azithromycin stops bacteria from growing by interfering with how they build their own parts. It attaches to a tiny part inside the bacteria called a ribosome, which stops the bacteria from making important instructions.

This medicine can be taken by mouth without any special protection because it stays strong in the stomach. It gets absorbed into the body better when the stomach is empty. The medicine reaches its highest level in the body within a few hours. It collects in the parts of the body that fight infections, making it very effective at the site of infection. The amount of the medicine in tissues can be much higher than in the blood. After one dose, the medicine stays in the body for many days. Most of the medicine leaves the body through bile, and a small amount is found in urine.

History

Azithromycin was discovered by researchers at a company called Pliva in Zagreb, Yugoslavia in 1980. Pliva got exclusive rights to sell it in Central and Eastern Europe, while Pfizer got rights for Western Europe and the United States. Pfizer started selling it under the name Zithromax in 1991. The patent for azithromycin ended in 2005.

Society and culture

Available forms

Azithromycin can be found as a regular medicine. It comes in many forms, such as coated tablets, capsules, liquid you drink, injections into a vein, granules you mix into a packet, and eye drops.

Usage

In 2010, azithromycin was the most prescribed antibiotic for people who see a doctor in the US. In Sweden, where fewer antibiotics are prescribed, it made up only a small part of prescriptions. By 2017 and 2022, it became the second most prescribed antibiotic in the United States. In 2022, it was the 78th most prescribed medicine overall in the US, with over 8 million prescriptions given out.

Research

Azithromycin is being studied for its ability to help control inflammation in the body. It works by affecting tiny proteins called cytokines that are involved in the immune system. Some studies show that azithromycin can lower the levels of certain cytokines that cause inflammation and increase others that reduce it. This might help protect tissues from damage during inflammatory reactions.

Researchers have looked at how azithromycin might help with diseases such as cystic fibrosis, asthma, and chronic obstructive pulmonary disease. While early lab studies suggested it might slow down the growth of the virus that causes COVID-19, later research showed it does not work as a treatment for the disease in people. Azithromycin is also being explored for its possible benefits in treating chronic fatigue syndrome and preventing infections in mothers after childbirth, though more research is needed to understand these effects better.