Zithromax, Azithromycin – an antibiotic with a difference – to make a difference

One medicine in many forms – tablets, gel, and oral suspension – that’s Zithromax for you.  The generic Azithromycin, the medicinal compound in Zithromax, has a wide-ranging effect and can be used effectively against various infections that result from bacterial action in the nasal passage, respiratory, gastrointestinal and genito-urinary tracts, skin and soft tissue, otitis media [an infection of the middle ear], typhoid in the early stages, or nosocomially-acquired infections.

Generic Azithromycin, an antibiotic medicine, belongs to the Erythromycin group of drugs.  Azithromycin is an azalide, having a similar mechanism to Erythromycin [a macrolide], but with improved functions to cover a wide gamut of bacterial infections that may occur in the nasal passages or throat [sinusitis, pharyngitis, or tonsillitis], lungs and airways [bronchitis, or pneumonia], skin and soft tissue infections, middle ear infection [otitis media], genito-urinary tract [uncomplicated urethritis, or cervicitis as in N.gornnorhoeae, or cervical and rectal chlamydia], and in the treatment of mild to moderate typhoid.  Its action is bacteriostatic rather than bactericidal – it does not kill the bacteria directly, but inhibits the protein synthesis to take place in the bacteria, that ultimately causes them to perish.  The remaining bacteria are killed by the body’s refurbished immune system.

In the last few years, it has proved to be an effective medicine for preventing bacterial infections in babies and in those who have weak immune systems.  The medicine is readily absorbed.  The drug is often used alongwith another antibiotics to treat mycobacterium avium complex – MAC – an “opportunistic infection” in HIV-ridden people.  It is also used in the treatment of patients who have mild to moderate typhoid.  Azithromycin is administered to those who develop a urinary tract infection or pneumonia following a surgery – a nosocomially acquired infection in the hospital, due to infection caused by inadequate hygienic measures or equipment in the hospital.

It helps to treat women, and men who have chlamydia, a common sexually-transmitted disease [caused by a tiny bacteria, the chlamydia trachomatis], considered to be a common preventable factor for causing infertility in women.  If not treated, chlamydia can cause inflammation of the pelvis, and damage the Fallopian tubes that transport ovarian eggs to the womb.  Such women can also conceive, but run the risk of having an ectopic pregnancy – when the fetus develops in the Fallopian tubes instead of the womb, that can make split the tubes, making it a life-threatening situation.  Perihepatitis, a liver disease, causing symptoms of pain, nausea, anorexia and abdominal palpation, due to chlamydia, may at times, occur in women.

In men, if chlamydia is left untreated, it impacts the sperm function and male fertility.  It can lead to, though not so commonly, to reactive arthritis in men.  In the latter condition, previously called Reiter syndrome, it affects the joints [wrists, knees, ankles, feet], eyes, gastrointestinal or genito-urinary tract, bringing stiffness, inflammation and pain.  It’s a systemic rheumatic disease that can cause inflammation in other organs, and tissues around the mouth, kidneys, heart, lungs, spine, as well as the skin.

Zithromax is one of the few antibiotics found to be effective in treating chlamydia – just a single dose for 7-10 days if detected at the onset.  Sometimes chlamydia occurs without any symptoms.  The risk of untreated pregnant women having an STD passing on the infection to their unborn babies is always present.  Its occurrence is found in adolescents as well.  Prompt treatment can save all such affected people from further health problems.  Since this is a sexually-transmitted disease, its necessary to get the partner treated also, otherwise the treated person can get re-infected.

Zithromax [Generic] is an acid-stable medication that can be taken an hour or two before or after food, but considered to be more effective when taken on an empty stomach.  The oral suspension can be taken regardless of food.  Take the medicine as advised by your physician. Antibiotics generally lead to a ‘good’ feeling soon after the therapy starts, but its important to finish the course, as leaving it mid-way will make the infection to return, and no antibiotic treatment may be able to help then.  When given to children, the liquid dose should be measured with the special measuring spoon meant for such medicines, so that the right amount is given.

When you approach your physician, the doctor will want to know your medical history, especially if you have a liver disease, cystic fibrosis, bacteremia, irregular heartbeats, HIV, have a nosocomially acquired disease [acquired in a hospital after a surgery, such as UTI or pneumonia], or if you do not have a spleen.  Zithromax [Azithromycin] interacts with a large number of drugs, and you must give details of all the medicines [OTC, prescription] as well as the nutritional supplements and herbal products you may be taking, so that your physician can decide what medicines you can continue to take and work out the correct dose regimen for you.  This medicine is contraindicated if you are taking other antibiotics like Erythromycin, Clarithromycin or Dirithromycin, or medicines like Mizolastine, Pimozide or Reboxetine.  Inform the treating doctor if you have any specific allergy, or if you are allergic to Zithromax.

Azithromycin is not given to infants who are below 6 months in age, while only the suspension dose is recommended for children who weigh below 45kg.  The medicine is not recommended for the geriatric population.  Patients who want to take the Oral Typhoid vaccine must wait for at least 3 days after finishing a course of Zithromax, because combined usage with this medicine, will make the vaccine less effective.  Zithromax is said to enhance the anti-blood-clotting effects of Warfarin and other anti-coagulants, so the doctor will want to monitor the blood clotting time of such patients, and also monitor the blood levels of patients who are taking Digoxin or Ciclosporin alongwith a course of Azithromycin.  It is recommended that this medicine should be taken 1 hour before or 2 hours after taking any antacid.

Pregnant or lactating women, besides those who are planning a pregnancy, must inform the physician about their condition before taking the medicine; while those taking Oral Birth Control pills may not be given Azithromycin, as this is liable to negate the effect of the Birth Control pills and can cause an unwanted pregnancy.

Side-effects of this medicine are minor, and few; these include: nausea, vomiting, diarrhea, or abdominal pain.  If these worsen or persist, or any other unusual symptoms occur such as a rash, itching, inflamed vagina, dizziness, convulsions, thrush infections, palpitation, anxiety, anemia, changes in hearing or taste sensation, or a ‘pins and needles’ sensation, then you must discontinue the medicine immediately and contact your doctor, seeking emergency help if necessary.  

Store the medicine at a room temperature of 15oC-30oC, away from moisture, heat and light; the suspension may be kept in the fridge, but not in the freezer.  Keep this medicine out of reach of children and pets, discarding unused medicine after 10 days.  Never share your medicine with anyone.