Azithromycin Uses

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How do you administer this medicine?

What is Azithromycin?

Azithromycin injection is used to treat bacterial infections in many different parts of the body. It is also used to prevent Mycobacterium avium complex (MAC) disease in patients infected with the human immunodeficiency virus (HIV).

Azithromycin belongs to the class of drugs known as macrolide antibiotics. It works by killing bacteria or preventing their growth. However, Azithromycin will not work for colds, flu, or other virus infections. Azithromycin injection may be used for other problems as determined by your doctor.

Azithromycin is available only with your doctor's prescription.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, Azithromycin is used in certain patients with the following medical condition:

Azithromycin indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Azithromycin Tablets and other antibacterial drugs, Azithromycin Tablets should be used only to treat infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Azithromycin Tablets are a macrolide antibacterial drug indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the specific conditions listed below.

Mycobacterial Infections

Prophylaxis of Disseminated Mycobacterium avium complex (MAC) Disease

Azithromycin Tablets, taken alone or in combination with rifabutin at its approved dose, are indicated for the prevention of disseminated MAC disease in persons with advanced HIV infection.

Treatment of Disseminated MAC Disease

Azithromycin Tablets, taken in combination with ethambutol, are indicated for the treatment of disseminated MAC infections in persons with advanced HIV infection.

How should I use Azithromycin?

Use Azithromycin drops as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Azithromycin drops.

Uses of Azithromycin in details

There are specific as well as general uses of a drug or medicine. A medicine can be used to prevent a disease, treat a disease over a period or cure a disease. It can also be used to treat the particular symptom of the disease. The drug use depends on the form the patient takes it. It may be more useful in injection form or sometimes in tablet form. The drug can be used for a single troubling symptom or a life-threatening condition. While some medications can be stopped after few days, some drugs need to be continued for prolonged period to get the benefit from it.

Use: Labeled Indications

Oral, IV:

Chancroid: Treatment of genital ulcer disease (in men) due to Haemophilus ducreyi (chancroid)

Chronic obstructive pulmonary disease, acute exacerbation: Treatment of acute bacterial exacerbations of chronic obstructive pulmonary disease (COPD) due to Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumoniae

Mycobacterium avium complex: Prevention of Mycobacterium avium complex (MAC) in patients with advanced HIV infection; treatment of disseminated MAC (in combination with ethambutol) in patients with advanced HIV infection

Otitis media, acute: Treatment of acute otitis media due to H. influenzae, M. catarrhalis, or S. pneumoniae

Pneumonia, community-acquired: Treatment of community-acquired pneumonia (CAP) due to Chlamydophila pneumoniae, H. influenzae, Legionella pneumophila, M. catarrhalis, Mycoplasma pneumoniae, or S. pneumoniae

Skin and skin structure infection, uncomplicated: Treatment of uncomplicated skin and skin structure infections due to Staphylococcus aureus, Streptococcus pyogenes, or Streptococcus agalactiae

Streptococcal pharyngitis (group A): Treatment of pharyngitis/tonsillitis due to S. pyogenes as an alternative to first-line therapy

Urethritis/cervicitis: Treatment of urethritis and cervicitis due to Chlamydia trachomatis or Neisseria gonorrhoeae

Off Label Uses

Acne vulgaris

Data from controlled trials support the use of Azithromycin in the treatment of acne vulgaris in adults with moderate to severe acne.

Based on the American Academy of Dermatology guidelines of care for the management of acne vulgaris, Azithromycin, in combination with topical therapy, may be considered as a treatment option for moderate and severe acne and forms of inflammatory acne that are resistant to topical treatments. However, its use should be limited to patients who cannot receive a tetracycline (ie, pregnant women). Concomitant topical therapy with benzoyl peroxide or a retinoid should be administered with systemic antibiotic therapy (eg, Azithromycin) and continued for maintenance after the antibiotic course is completed.


Data from a prospective, nonblinded, randomized trial in patients with non-life-threatening babesiosis, support the use of Azithromycin (in combination with atovaquone) for the treatment of this condition.

Based on the CDC Yellow Book, the ACG guideline for the diagnosis, treatment, and prevention of acute diarrheal infections in adults, and the IDSA practice guidelines for the diagnosis and management of infectious diarrhea, Azithromycin is effective and recommended treatment for patients with travelers' diarrhea. Due to increased levels of resistance to fluoroquinolones, Azithromycin may be a recommended first-line treatment, especially in regions with a high prevalence of Campylobacter (eg, Southeast Asia, India) or in geographical areas with suspected fluoroquinolone-resistant pathogens or enterotoxigenic Escherichia coli.

Azithromycin description


Each film-coated tablet contains Azithromycin dihydrate equivalent to Azithromycin 500 mg.

Azithromycin is a nitrogen-containing macrolide or azalide with actions and uses similar to those of erythromycin. Azithromycin is derived from erythromycin. However, it differs chemically from erythromycin in that a methyl-substituted nitrogen atom is incorporated into the lactone ring.

Azithromycin dosage

Tablet: Adults: Usual Dose: 500 mg as a single dose daily for 3 days. Alternatively, an initial dose of 500 mg may be followed by 250 mg daily for a further 4 days.

Uncomplicated Genital Infections Caused by Chlamydia trachomatis and for Chancroid: 1 g given as a single dose.

Uncomplicated Gonorrhoea: A single dose of 2 g has been given.

Treatment of Granuloma Inguinale: Initially, 1 g followed by 500 mg daily may be given or 1 g may be given once a week for at least 3 weeks, until all lesions have completely healed.

Mild or Moderate Typhoid Caused by Multidrug-Resistant Strains: 500 mg once daily may be given for 7 days.

Injection: Treatment of Mild to Moderate CAP in Adults: 500 mg given as a single dose on the 1st day of therapy, followed by 250 mg once daily on days 2-5. Total Cumulative Dose: 1.5 g administered over 5 days.

Treatment of CAP in Adults or Adolescents ≥16 years who Require Initial IV Therapy: 500 mg given IV as a single daily dose for 2 days. IV therapy generally is followed by oral Azithromycin given as a single, daily 500-mg dose to complete a 7-10 days of therapy. The timing of the change from IV to oral therapy should be individualized by the physician, taking into account the clinical response of the patient.

Treatment of Acute PID in Patients Requiring Initial IV Therapy: 500 mg given IV as a single daily dose for 1-2 days. If anaerobic bacteria are suspected, an anti-infective active against anaerobes should also be used. IV therapy generally is followed by oral Azithromycin 250 mg once daily to complete a 7-day course of therapy. The timing of the change from IV to oral therapy should be individualized by the physician, taking into account clinical response of the patient.

Administration: Azithromycin for IV infusion must be reconstituted and be further diluted prior to administration. Azithromycin powder for injection is for IV use only.

IV solutions containing Azithromycin in a concentration of 1 mg/mL generally are infused over 3 hrs and solutions containing Azithromycin 2 mg/mL generally are infused over 1 hr.

Azithromycin interactions

See also:
What other drugs will affect Azithromycin?


Antacids: In a pharmacokinetic study investigating the effects of simultaneous administration of antacid with Azithromycin, no effects on overall bioavailability was seen although peak serum concentrations were reduced by up to 30%. In patients receiving both Azithromycin and antacids, the drug should not be taken simultaneously.

Carbamazepine: In a pharmacokinetic interaction study in healthy volunteers, no significant effect was observed on the plasma levels of carbamazepine or its active metabolite in patients receiving concomitant Azithromycin.

Cimetidine: A single dose of cimetidine administered 2 hrs before Azithromycin had no effect on the pharmacokinetics of Azithromycin.

Cyclosporin: In the absence of conclusive data from pharmacokinetics or clinical studies investigating potential interaction between Azithromycin and cyclosporin, caution should be exercised before concurrent administration of these drugs. If co-administration of these drugs is necessary, cyclosporin levels should be monitored and the dose adjusted accordingly.

Digoxin: Some of the macrolide antibiotics have been reported to impair the metabolism of digoxin (in the gut) in some patients. Therefore, in patients receiving concomitant Azithromycin and digoxin, the possibility of raised digoxin levels should be bourne in mind, and digoxin levels monitored.

Ergot Derivatives: Because of the theoretical possibility of ergotism, Azithromycin and ergot derivatives should not be co-administered.

Methylprednisolone: In a pharmacokinetic interaction study in healthy volunteers, Azithromycin had no significant effect on the pharmacokinetics of methylprednisolone.

Terfenadine: Pharmacokinetic studies have reported no evidence of an interaction between Azithromycin and terfenadine. There have been rare cases reported where the possibility of such an interaction could not be entirely excluded; however, there was no specific evidence that such an interaction had occured.

Theophylline: There is no evidence of any pharmacokinetic interaction when Azithromycin and theophylline are co-administered in healthy volunteers.


Oral Anticoagulants:

In a pharmacodynamic interaction study, Azithromycin did not alter the anticoagulant effect of a single dose warfarin 15 mg administered to healthy volunteers. There have been reports received in the post-marketing period of potentiated anticoagulant subsequent to co-administration of Azithromycin and coumarin-type oral anticoagulants. Although a causal relationship has not been established, consideration should be given to the frequency of monitoring prothrombin time when Azithromycin is used in patients receiving coumarin-type oral anticoagulants.

Zidovudine: Single 1000 mg doses, and multiple 1200 mg or 600 mg doses of Azithromycin did not affect the plasma pharmacokinetics or urinary excretion of zidovudine or its glucuronide metabolite. However, administration of Azithromycin increased the concentrations of phosphorylated zidovudine, the clinically active metabolite, in peripheral blood mononuclear cells. The clinical significance of this finding is unclear, but it may be of benefit to patients.

Didanosine: Co-administration of daily doses of Azithromycin 1200 mg with didanosine in 6 subjects did not appear to affect the pharmacokinetics of didanosine as compared with placebo.

Rifabutin: Co-administration of Azithromycin and rifabutin did not affect the serum concentrations of either drug. Neutropenia was observed in subjects receiving concomitant treatment of Azithromycin and rifabutin. Although neutropenia has been associated with the use of rifabutin, a causal relationship to combination with Azithromycin has not been established.

Azithromycin side effects

See also:
What are the possible side effects of Azithromycin?

Azithromycin is well tolerated with a low incidence of side effect. Palpitations and arrhythmias including ventricular tachycardia (as seen with other macrolides) have been reported although a causal relationship to Azithromycin has not been established.

Dizziness/vertigo, convulsions (as seen with other macrolides), headache, somnolence, paraesthesia and hyperactivity.

Anorexia, nausea, vomiting/diarrhea (rarely resulting in dehydration), loose stools, dyspepsia, abdominal discomfort (pain/cramps), constipation, flatulence, pseudomembranous colitis and rare reports of tongue discolouration.

Asthenia has been reported although a causal relationship has not been established, moniliasis and anaphylaxis (rarely fatal).

Interstitial nephritis and acute failure.


Abnormal liver function including hepatitis and cholestatic jaundice have been reported, as well as rare cases of hepatic necrosis and hepatic failure, which have rarely resulted in death.

However, a causal relationship has not been established.


Aggressive reaction, nervousness, agitation and anxiety.


Allergic reactions including pruritus, rash, photosensitivity, oedema, urticaria and angioedema. Rarely, serious skin reactions including erythema multiforme, Stevens-Johnsons syndrome and toxic epidermal necrolysis have occured.

Hearing impairment has been reported with macrolide antibiotics. There have been reports of hearing impairment, including hearing loss, deafness and/or tinnitus in some patients receiving Azithromycin. Many of these have been associated with prolonged use of high doses in investigational studies. In those cases where follow-up information was available, the majority of theses events were reversible.

There have been reports of taste perversion. Transient episodes of mild neutropenia have occasionally been observed in clinical trials, although a causal relationship to Azithromycin has not been established.

Azithromycin contraindications

See also:
What is the most important information I should know about Azithromycin?


Azithromycin Tablets are contraindicated in patients with known hypersensitivity to Azithromycin, erythromycin, any macrolide, or ketolide drug.

Hepatic Dysfunction

Azithromycin Tablets are contraindicated in patients with a history of cholestatic jaundice/hepatic dysfunction associated with prior use of Azithromycin.

Active ingredient matches for Azithromycin:


Unit description / dosage (Manufacturer)Price, USD
Tablet, Film-Coated; Oral; Azithromycin Monohydrate 250 mg
Injectable; Injection; Azithromycin 500 mg
Capsule; Oral; Azithromycin Dihydrate 250 mg
Tablet; Oral; Azithromycin 500 mg
Capsule; Oral; Azithromycin 250 mg
Injectable; Injection; Azithromycin Hydrogencitrate 2.5 g
Injectable; Injection; Azithromycin Hydrogencitrate 500 mg
Tablet; Oral; Azithromycin 250 mg
Tablet; Oral; Azithromycin 600 mg
Tablet, Film-Coated; Oral; Azithromycin Monohydrate 500 mg
Suspension; Oral; Azithromycin 100 mg / 5 ml
Suspension; Oral; Azithromycin 200 mg / 5 ml
Tablet, Film-Coated; Oral; Azithromycin 250 mg
Tablet, Film-Coated; Oral; Azithromycin 500 mg
Zithromax 3 1 gm Packets Box$ 118.26
Azithromycin 2.5 gm bulk vial$ 75.60
Zmax adult-ped 2 g/60 ml susp$ 70.39
Zithromax Tri-Pak 3 500 mg tablet Disp Pack$ 69.67
Zithromax Z-Pak 6 250 mg tablet Disp Pack$ 68.62
Zmax 2 g/60 ml susp sr$ 67.04
Zmax pediatric 2 g/60 ml susp$ 67.04
Zithromax 200 mg/5ml Suspension 30ml Bottle$ 52.00
Zithromax 100 mg/5ml Suspension 15ml Bottle$ 51.60
Zithromax 200 mg/5ml Suspension 15ml Bottle$ 50.46
Zithromax 200 mg/5ml Suspension 22.5ml Bottle$ 50.46
Azithromycin 3 500 mg tablet Disp Pack$ 48.52
Azithromycin 6 250 mg tablet Disp Pack$ 48.52
Azasite 1% eye drops$ 42.85
Zithromax i.v. 500 mg vial$ 34.39
Azithromycin 200 mg/5ml Suspension 15ml Bottle$ 34.25
Zithromax 600 mg tablet$ 27.22
Zithromax 500 mg tablet$ 22.68
Zithromax tri-pak 500 mg tablet$ 22.24
Azithromycin 600 mg tablet$ 19.04
Azithromycin 500 mg tablet$ 15.87
Trimox 125 mg/5ml Suspension 100ml Bottle$ 11.99
Trimox 125 mg/5ml Suspension 150ml Bottle$ 11.99
Trimox 250 mg/5ml Suspension 80ml Bottle$ 11.99
Zithromax 250 mg z-pak tablet$ 11.12
Azithromycin i.v. 500 mg vial$ 11.09
Azithromycin powder$ 10.89
Zithromax 250 mg tablet$ 9.41
Azithromycin 250 mg tablet$ 6.33
Apo-Azithromycin 250 mg Tablet$ 3.11
Co Azithromycin 250 mg Tablet$ 3.11
Mylan-Azithromycin 250 mg Tablet$ 3.11
Novo-Azithromycin 250 mg Tablet$ 3.11
Phl-Azithromycin 250 mg Tablet$ 3.11
Pms-Azithromycin 250 mg Tablet$ 3.11
Ratio-Azithromycin 250 mg Tablet$ 3.11
Sandoz Azithromycin 250 mg Tablet$ 3.11
Zithromax 40 mg/ml Suspension$ 1.70
Zithromax 20 mg/ml Suspension$ 1.20
Novo-Azithromycin 40 mg/ml Suspension$ 0.95
Pms-Azithromycin 40 mg/ml Suspension$ 0.95
Sandoz Azithromycin 40 mg/ml Suspension$ 0.95
Novo-Azithromycin 20 mg/ml Suspension$ 0.67
Pms-Azithromycin 20 mg/ml Suspension$ 0.67
Sandoz Azithromycin 20 mg/ml Suspension$ 0.67
Tablets, Film-Coated; Oral; Azithromycin Monohydrate 250 mg
Capsules; Oral; Azithromycin Dihydrate 250 mg
Tablets; Oral; Azithromycin 500 mg
Capsules; Oral; Azithromycin 250 mg
Injectable; Injection; Azithromycin Hydrogen Citrate 2.5 g
Injectable; Injection; Azithromycin Hydrogen Citrate 500 mg
Tablets; Oral; Azithromycin 250 mg
Tablets; Oral; Azithromycin 600 mg
Tablets, Film-Coated; Oral; Azithromycin Monohydrate 500 mg
Tablets, Film-Coated; Oral; Azithromycin 250 mg
Tablets, Film-Coated; Oral; Azithromycin 500 mg
Azithromycin tablet, film coated 600 mg/1 (REMEDYREPACK INC. (US))
Azithromycin tablet 600 mg (Sanis Health Inc (Canada))
Azithromycin tablet 250 mg (4513347 Canada Inc. (Canada))
Azithromycin tablet, film coated 250 mg/1 (Department Of State Health Services, Pharmacy Branch (US))
Azithromycin tablet, film coated 500 mg/1 (REMEDYREPACK INC. (US))
Azithromycin tablet 500 mg/1 (REMEDYREPACK INC. (US))
Azithromycin injection 500 mg/10mL (Apotex Corp. (US))

List of Azithromycin substitutes (brand and generic names):

AZITHROMYCIN 100MG DT TABLET 1 strip / 10 tablets each (Jan Aushadhi)$ 0.34
AZITHROMYCIN 100MG/ 5ML SYRUP 1 bottle / 15 ML syrup each (Jan Aushadhi)$ 0.25
AZITHROMYCIN 250MG TABLET 1 strip / 10 tablets each (Jan Aushadhi)$ 1.10
AZITHROMYCIN 500MG TABLET 1 strip / 10 tablets each (Jan Aushadhi)$ 2.15
Azithromycin Actavis film-coated tab 250 mg 15's (Actavis)
Azithromycin Actavis film-coated tab 250 mg 6's (Actavis)
Azithromycin Actavis film-coated tab 500 mg 15's (Actavis)
Azithromycin Actavis film-coated tab 500 mg 3's (Actavis)
Azithromycin Bidiphar 250 mg x 1 Blister x 6 Tablet


  1. DailyMed. "AZITHROMYCIN: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". (accessed September 17, 2018).
  2. PubChem. "azithromycin". (accessed September 17, 2018).
  3. DrugBank. "azithromycin". (accessed September 17, 2018).


The results of a survey conducted on for Azithromycin are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Azithromycin. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

User reports

1 consumer reported useful

Was the Azithromycin drug useful in terms of decreasing the symptom or the disease?
According to the reports released by website users, the below mentioned percentages of users say the drug is useful / not useful to them in decreasing their symptoms/disease. The usefulness of the drug depends on many factors, like severity of the disease, perception of symptom, or disease by the patient, brand name used [matters only to a certain extent], other associated conditions of the patient. If the drug is not effective or useful in your case, you need to meet the doctor to get re-evaluated about your symptoms/disease, and he will prescribe an alternative drug.

Consumer reported price estimates

No survey data has been collected yet

7 consumers reported time for results

To what extent do I have to use Azithromycin before I begin to see changes in my health conditions?
As part of the reports released by website users, it takes 3 days and a few days before you notice an improvement in your health conditions.
Please note, it doesn't mean you will start to notice such health improvement in the same time frame as other users. There are many factors to consider, and we implore you to visit your doctor to know how long before you can see improvements in your health while taking Azithromycin. To get the time effectiveness of using Azithromycin drug by other patients, please click here.
3 days4
5 days1
2 days1
1 week1

11 consumers reported age

> 601

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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