Azithromycin

It has greater activity than Erythromycin against some gram negative microorganism as Haemophilus influenza, and Moraxella catarrhalis but less active then Erythromycin against Streptococci macrophages & polymorphs. Effective against intracellular pathogens such as mycoplasma, chlamydia, legionella & salmonella. it is a nitrogen conataining macrolide
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Mechanism of Action:                                                                                                                                     It has mainly bacteriostatic activity. It is obtained from Streptomyces erythreus in 1952. It is highly effective against Streptococcus and Staphylococcus infection. Various Erythromycin Derivatives are made as film and enteric coated tablets as to protect from HCL of the stomach. it is bitter in taste.

Indication:

•  Micobacterium avium complex (MAC) infection 
•  Upper respiratory tarct infection (Laryngitis, tonsilitis, sinusitis) 
•  Enteric fever (typhoid)
•  Lower respiratory tract infection  (bronchitis, pneumonia)
•  Genitourianry tract infection 
•  Otitis media 
•  Uncomplicated genital clamidial infections
•    Skin and soft tissue infection   

Does:

        Adult: 500mg as a single dose for 3 days.or (alternatively initial dose of 500mg and followed by 

        250mg daily of a further 4 days).Uncomplicated genital infection 1gm as a single dose but 2gm 

        for uncomplicated gonorrhoea. for MAC infection 1.2gm  once weekly 

        Enteric fever 20mg/kg/day Od (upto 1gm/day)

        Child; 5-10mg/kg/day for three days 

Adverse effect;

      CNS: dizziness, headache, vertigo, agitation

      GIT: nausea, vomiting, epigastric discomfort, diarrhoea 

      Liver: cholestatic jaundice,elevation in hepatic enzymes

      Urinary: nephritis, acute renal failure

      CVS: palpitation, ventricular arrhythmias, hypotension 

      Ear: ototoxicity 

      Skin: rashes, urticaria, angioedema, Stevens-johnson syndrome

Drug interaction:

• Concurrent administration of antacid can reduce the rate of absorption of Azithromycin.

Contraindication:

         Hepatic important, Hypersensivity to maceolides.