Zithromax (azithromycin) is a wide-spectrum antibiotic that fights bacteria. It is used to treat many different types of infections caused by bacteria.


This is an antibiotic of the macrolide group with a bacteriostatic effect (inhibits the growth of pathogens). It is active against a wide range of germs. The mechanism of action is associated with the suppression of protein production in microbe cells. In high concentrations, it can have a bactericidal (killing microbes) effect.

Microorganisms that are sensitive to azithromycin: gram-negative aerobes (Neisseria gonorrhoeae, Moraxella catarrhalis, Haemophilus parainfluenzae, Legionella pneumophila, Haemophilus influenzae, Pasteurella multocida), gram-positive aerobes (Staphylococcus aureus p. Pyreus P. pyogenesis P. anogenus P. pyogenum pyrophobia. spp., Clostridium perfringens, Porphyriomonas spp.), others (Chlamydia phneumoniae, Chlamydia trachomatis, Chlamydia psittaci, Mycoplasma hominis, Mycoplasma pneumoniae, Borrelia burgdorferi).

Microbes that can develop resistance to azithromycin: gram-positive aerobes (penicillin-resistant Streptococcus pneumoniae).

Azithromycin-resistant microorganisms: gram-positive aerobes (Staphylococci, Enterococcus faecalis), Bacteroides fragilis.

Zithromax is indicated for use in infectious processes caused by microbes sensitive to this antibiotic: infections of the ENT organs, upper respiratory tract (sinusitis, tonsillitis, pharyngitis, otitis media, rhinitis, laryngitis, tracheitis), lower respiratory tract infections (bronchitis, pneumonia), infections of soft tissues, skin (impetigo, secondarily infected dermatosis, erysipelas, acne vulgaris), migratory eri EMA – the initial symptom of borreliosis (Lyme disease), urinary tract infection provoked by Chlamydia infection (urethritis, cervicitis).


Zithromax should not be taken if you have hypersensitivity (allergies) to macrolide antibiotics, severe impairment of the kidneys, liver (their insufficiency), or if you are taking ergotamine, dihydroergotamine. The drug is not used in children under 12 years (or weighing less than 45 kg).

The drug is used with caution in moderate impairment of the kidneys, liver, arrhythmias, predisposition to arrhythmias, lengthening of the Q-T interval (on an ECG), or in patients taking terfenadine, digoxin, warfarin.

Pregnancy and breastfeeding

Zithromax is used during pregnancy only when the need for treatment of the mother exceeds the possible risks for the child.

This antibiotic can be excreted in mother’s milk, so it is not used during lactation.

Dosage and administration

Take the tablet orally, with water.

The dose is taken once a day, one hour or two hours after a meal.

  • Infections of the ENT organs, lower or upper respiratory tract, soft tissues, skin: 0.5 g / day for three days (dose per course – 1.5 g);
  • Erythema migrans: 1 g on the 1st day, from the 2nd to the 5th day – 0.5 g daily (dose for a 5-day course is 3 g);
  • Common acne (acne vulgaris): 0.5 g / day for three days, then 0.5 g / day once a week for nine weeks (6 g per course). The first weekly pill should be taken seven days after taking the first daily pill (that is, 8 days from the start of treatment), the next 8 weekly tablets are taken at intervals of 7 days;
  • Chlamydial infections of the genitourinary tract (infection with Chlamidia trachomatis): 1 g is prescribed once.

Patients with impaired renal function: a dose adjustment is not required.

If you missed one dose of the drug, take it as early as possible, the next dose is taken with an interval of 24 hours.

The doctor should take into account that treatment with azithromycin can cause superinfection, including fungal infection.

The antibiotic must be taken at least an hour before or two hours after using drugs that reduce the acidity of gastric juice (antacids).


Symptoms of an overdose: urge to vomit, temporary hearing loss, frequent and loose stools.

Overdose treatment: emergency gastric lavage, including the use of sorbents (activated charcoal), symptomatic treatment.

Side effects

  • Disorders of the circulatory, lymphatic systems: a decrease in the number of platelets (thrombocytopenia), neutrophilic leukocytes (neutropenia);
  • Disorders of the central nervous system: vertigo (dizziness), convulsions, cephalalgia (headache), paresthesia (tingling sensation, crawling, burning sensation on the skin), drowsiness, powerlessness, insomnia, increased motor activity, aggressiveness, nervousness, anxiety;
  • Perceptual disorders: reversible hearing impairment, deafness, tinnitus, impaired perception of taste, smell;
  • Disorders of the cardiovascular system: rhythm disturbance (arrhythmia, palpitations, ventricular tachycardia, extension of the Q-T interval on the ECG, bidirectional ventricular tachycardia);
  • Digestive tract disorders: stool disorders (constipation, diarrhea), nausea, abdominal pain / cramps, flatulence (bloating), anorexia (lack of appetite), discoloration of the tongue, inflammation of the colon (pseudomembranous colitis), cholestatic jaundice (due to a violation of the outflow of bile ), hepatitis (inflammation of the liver), a change in laboratory liver tests, liver failure, liver necrosis (decay), sometimes fatal;
  • Allergic reactions: angioedema (rapid swelling of the face, lips, tongue with respiratory failure), itching, rash, urticaria, photosensitivity (sensitivity to the sun), anaphylactic shock (fatal in rare cases), erythema multiforme, allergic contact dermatitis;
  • Movement disorders: arthralgia (joint pain);
  • Genitourinary disorders: nephritis (inflammation of the kidneys), acute kidney failure;
  • Other: candidiasis (fungal infection), vaginitis (vaginal inflammation).

Drug interactions

Do not combine Zithromax with any of the following drugs:

  • antacids (aluminum and magnesium);
  • warfarin;
  • digoxin;
  • ergotamine and dihydroergotamine;
  • triazolam;
  • cycloserine, indirect anticoagulants, methylprednisolone, felodipine, as well as drugs subjected to microsomal oxidation (carbamazepine, terfenadine, cyclosporine, hexobarbital, ergot alkaloids, valproic acid, disopyramide, etc.;
  • lincosamides;
  • heparin.

Special instructions

Do not take the drug with food.

If you have symptoms of impaired liver function, such as rapidly growing asthenia, jaundice, dark urine, a tendency to bleed, hepatic encephalopathy, therapy with Zithromax should be discontinued and a study of the functional state of the liver should be conducted.

If you have impaired renal function of mild to moderate severity (CC more than 40 ml/min), the antibiotic should be used with caution.

During therapy with this drug, patients should be regularly examined for the presence of immune microorganisms and signs of superinfection.

The drug should not be used for longer courses than indicated in the instructions since the pharmacokinetic properties of azithromycin make it possible to recommend a short and simple dosage regimen.

There is no data on the possible interaction between azithromycin and derivatives of ergotamine and dihydroergotamine, but due to the development of ergotism with the simultaneous use of macrolides with derivatives of ergotamine and dihydroergotamine, this combination is not recommended.

With prolonged use of the drug, pseudomembranous colitis caused by Clostridium difficile can develop, both in the form of mild diarrhea and severe colitis.

If you have antibiotic-associated diarrhea while taking Zithromax, clostridial pseudomembranous colitis should be excluded. Drugs that inhibit intestinal motility are contraindicated for use.

In the treatment with azithromycin may cause an increase in cardiac repolarization and QT interval, increasing the risk of developing cardiac arrhythmias, including pirouette type arrhythmias.

The use of the drug can provoke the development of myasthenic syndrome or cause an exacerbation of myasthenia gravis.

After treatment is canceled, hypersensitivity reactions may persist in some patients, which requires specific therapy under the supervision of a physician.

The patient should take into account that during the period of treatment it is necessary to refrain from engaging in hazardous labor, requiring a high concentration of attention, quick reactions, as well as driving vehicles.