PO (Adults) 500 mg on 1st day, then 250 mg/day for 4 more days (total dose of 1.5 g); Acute bacterial sinusitis– 500 mg once daily for 3 days.
PO (Children ≥ 6 mo) Pneumonia/Pertussis– 10 mg/kg (not to exceed 500 mg/dose) on 1st day, then 5 mg/kg once daily (not to exceed 250 mg/dose) for 4 more days. Pharyngitis/tonsilitis– 12 mg/kg once daily for 5 days (not to exceed 500 mg/dose); Acute bacterial sinusitis– 10 mg/kg once daily for 3 days.
PO Neonates Pertussis, treatment and post-exposure prophylaxis– 10 mg/kg once daily for 5 days.
PO (Children ≥6 mo) 30 mg/kg single dose (not to exceed 1500 mg/dose) or 10 mg/kg once daily (not to exceed 500 mg/dose) for 3 days or 10 mg/kg (not to exceed 500 mg/dose) on 1st day, then 5 mg/kg once daily (not to exceed 250 mg/dose) for 4 more days.
Acute Bacterial Exacerbations of Chronic Bronchitis
PO (Adults) 500 mg on 1st day, then 250 mg once daily for 4 more days (total dose of 1.5 g) or 500 mg once daily for 3 days.
IV PO (Adults) More severe– 500 mg IV every 24 hr for at least 2 doses, then 500 mg PO every 24 hr for a total of 7–10 days; Less severe– 500 mg PO, then 250 mg/day PO for 4 more days.
PO (Children >6 mo) 10 mg/kg on 1st day, then 5 mg/kg once daily for 4 more days.
Pelvic Inflammatory Disease
IV PO (Adults) 500 mg IV every 24 hr for 1–2 days, then 250 mg PO every 24 hr for a total of 7 days.
Assess patient for infection (vital signs; appearance of wound, sputum, urine, and stool; WBC) at beginning of and throughout therapy.
Obtain specimens for culture and sensitivity before initiating therapy. First dose may be given before receiving results.
Observe for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Notify health care professional immediately if these occur.
Assess patient for skin rash frequently during therapy. Discontinue azithromycin at first sign of rash; may be life-threatening. Stevens-Johnson syndrome or toxic epidermal necrolysis may develop. Treat symptomatically; may recur once treatment is stopped.
Lab Test Considerations:
May cause ↑ serum bilirubin, AST, ALT, LDH, and alkaline phosphatase concentrations.
May cause ↑ creatine phosphokinase, potassium, prothrombin time, BUN, serum creatinine, and blood glucose concentrations.
For administration of single 1-g packet, thoroughly mix entire contents of packet with 2 oz (60 mL) of water. Drink entire contents immediately; add an additional 2 oz of water, mix and drink to assure complete consumption of dose. Do not use the single packet to administer doses other than 1000 mg of azithromycin. Pedi: 1-g packet is not for pediatric use.
Intermittent Infusion: Diluent: Reconstitute each 500-mg vial with 4.8 mL of sterile water for injection to achieve a concentration of 100 mg/mL. Reconstituted solution is stable for 24 hr at room temperature. Further dilute the 500-mg dose in 250 mL or 500 mL of 0.9% NaCl, 0.45% NaCl, D5W, LR, D5/0.45% NaCl, or D5/LR. Infusion is stable for 24 hr at room temperature or for 7 days if refrigerated.Concentration: Final concentration of infusion is 1–2 mg/mL.
Rate: Administer the 1-mg/mL solution over 3 hr or the 2-mg/mL solution over 1 hr. Do not administer as a bolus.
amphotericin B lipid complex
amphotericin B liposome
amphotericin B deoxycholate
Instruct patients to take medication as directed and to finish the drug completely, even if they are feeling better. Take missed doses as soon as possible unless almost time for next dose; do not double doses. Advise patients that sharing of this medication may be dangerous.
Instruct patient not to take azithromycin with food or antacids.
May cause drowsiness and dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
Advise patient to use sunscreen and protective clothing to prevent photosensitivity reactions.
Advise patient to report symptoms of chest pain, palpitations, yellowing of skin or eyes, or signs of superinfection (black, furry overgrowth on the tongue; vaginal itching or discharge; loose or foul-smelling stools) or rash.
Instruct patient to notify health care professional if fever and diarrhea develop, especially if stool contains blood, pus, or mucus. Advise patient not to treat diarrhea without advice of health care professional.
Advise patients being treated for nongonococcal urethritis or cervicitis that sexual partners should also be treated.
Instruct parents, caregivers, or patient to notify health care professional if symptoms do not improve.
Rep: Advise female patient of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding. Advise women to monitor breastfed infant for diarrhea, vomiting, or rash.
Resolution of the signs and symptoms of infection. Length of time for complete resolution depends on the organism and site of infection.
azithromycin is a sample topic from the Davis's Drug Guide.
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