Azithromycin dose pneumonia

Posted: NastyaW Date of post: 17-Feb-2019
<b>Azithromycin</b> Zithromax Side Effects, Dosages, Treatment. - RxList

Azithromycin Zithromax Side Effects, Dosages, Treatment. - RxList

Division of Infectious Diseases, Department of Medicine, Miller School of Medicine, University of Miami, Miami, FL 33136, USAReceived 22 August 2013; Accepted 26 November 2013; Published 21 January 2014Academic Editors: A. Rodriguez de Castro Copyright © 2014 Marilia Rita Pinzone et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Community acquired pneumonia (CAP) represents the most common cause of infection-related morbidity and mortality worldwide. Appropriate treatment of CAP is challenging and sometimes limited by the availability to obtain rapid and timely identification of the etiologic agent in order to initiate or deescalate the correct antimicrobial therapy. As a consequence, prescribers frequently select empiric antimicrobial therapy using clinical judgment, local patterns of antimicrobial resistance, and, sometimes, individual patient expectations. These issues may contribute to prolonged courses of inappropriate therapy. In this review, we discuss the evidence and recommendations from international guidelines for the management of CAP and the clinical trials that specifically addressed duration of antimicrobial therapy for CAP in adults. Major Finding: The cure rate did not differ between patients given the conventional 3-day regimen of IV azithromycin (87.9%) and patients given a single high IV dose of azithromycin (87.2%). Data Source: An open-label randomized trial among 72 adult outpatients with community-acquired pneumonia. Gattringer reported having no relevant conflicts of interest. The trial was supported by a grant from Pfizer Research. CHICAGO – Compressing the usual 3-day course of intravenous azithromycin into a single high dose appears to be a safe, efficacious alternative for treating community-acquired pneumonia in adult outpatients. In an open-label, randomized trial, investigators in Austria compared the same total dose of azithromycin either split over 3 days or given as a single infusion among 72 outpatients with community-acquired pneumonia (CAP). Trial results, reported at the annual Interscience conference on Antimicrobial Agents and Chemotherapy, showed that the two regimens had similar efficacy and adverse effect profiles. The single-dose strategy ensures high levels of the drug independent of patient compliance, according to presenting author Dr. Rainer Gattringer of the Elisabethinen Hospital and Analyse Bio Lab, both in Linz, Austria. "I think maybe physicians are a little bit afraid because it’s not written in the description of the drug that you can use it at 1.5 g as a single dose," he proposed in an interview. "So don’t be afraid, try it." The patients studied were 45 years old, on average, and 65% were men, according to data reported in a poster session. Gattringer noted; the CRB-65 (confusion, respiratory rate, blood pressure, and age 65 years or older) score was 0, 1, and 2 in 33.3%, 51.4%, and 15.3%, respectively.

<b>AZITHROMYCIN</b> Drug BNF content published by NICE

AZITHROMYCIN Drug BNF content published by NICE

Community-acquired pneumonia: Oral: -Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5 -Extended-release: 2 g orally once as a single dose Parenteral: 500 mg IV once a day as a single dose for at least 2 days, followed by 500 mg (immediate-release formulation) orally to complete a 7- to 10-day course of therapy Comment: Extended-release formulations should be taken on an empty stomach. Uses: -Treatment of mild community acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy -Treatment of community-acquired pneumonia due to C pneumoniae, H influenzae, Legionella pneumophila, Moraxella catarrhalis, M pneumoniae, or S pneumoniae in patients who require initial IV therapy Community-acquired pneumonia: Oral: -Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5 -Extended-release: 2 g orally once as a single dose Parenteral: 500 mg IV once a day as a single dose for at least 2 days, followed by 500 mg (immediate-release formulation) orally to complete a 7- to 10-day course of therapy Comment: Extended-release formulations should be taken on an empty stomach. Uses: -Treatment of mild community acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy -Treatment of community-acquired pneumonia due to C pneumoniae, H influenzae, Legionella pneumophila, Moraxella catarrhalis, M pneumoniae, or S pneumoniae in patients who require initial IV therapy Community-acquired pneumonia: Oral: -Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5 -Extended-release: 2 g orally once as a single dose Parenteral: 500 mg IV once a day as a single dose for at least 2 days, followed by 500 mg (immediate-release formulation) orally to complete a 7- to 10-day course of therapy Comment: Extended-release formulations should be taken on an empty stomach. Uses: -Treatment of mild community acquired pneumonia due to Chlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumoniae in patients appropriate for oral therapy -Treatment of community-acquired pneumonia due to C pneumoniae, H influenzae, Legionella pneumophila, Moraxella catarrhalis, M pneumoniae, or S pneumoniae in patients who require initial IV therapy Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5 Use: Treatment of pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in patients who cannot use first-line therapy IDSA Recommendations: Immediate-release: Individuals with penicillin allergy: 12 mg/kg orally once a day -Maximum dose: 500 mg/day -Duration of therapy: 5 days Use: Treatment of Group A streptococcal pharyngitis Immediate-release: 500 mg orally once a day for 3 days Extended-release: 2 g orally once as a single dose Comment: Extended-release formulations should be taken on an empty stomach. Use: Treatment of mild to moderate acute bacterial sinusitis due to H influenzae, M catarrhalis, or S pneumoniae Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5 Use: Treatment of mild to moderate uncomplicated skin and skin structure infections due to Staphylococcus aureus, Streptococcus pyogenes, or Streptococcus agalactiae IDSA and NIH Recommendations: Immediate-release: Patients greater than 45 kg: 500 mg orally on day 1, then 250 mg orally once a day on days 2 through 5 Patients less than 45 kg: 10 mg/kg orally on day 1, then 5 mg/kg orally once a day for 4 additional days Alternative therapy for Bartonella infections (not endocarditis or central nervous system infections): 500 mg orally once a day for at least 3 months Uses: -Treatment of bacillary angiomatosis and cat scratch disease -Alternative therapy for Bartonella infections Gonococcal urethritis and cervicitis: Immediate-release: 2 g orally once Use: Treatment of mild to moderate urethritis and cervicitis due to Neisseria gonorrhoeae US Centers for Disease Control and Prevention (CDC) Recommendations: Immediate-release: -Recommended regimen: 1 g orally once as a single dose plus ceftriaxone -Alternative regimen: 1 g orally once as a single dose plus cefixime Comments: -The alternative regimen may be used for uncomplicated infections if ceftriaxone is unavailable. -Arthritis and arthritis-dermatitis syndrome may be treated with 1 g orally once plus cefotaxime OR ceftizoxime. Uses: -Uncomplicated gonococcal infections of the pharynx, cervix, urethra, and rectum -Treatment of gonococcal conjunctivitis -Treatment of arthritis and arthritis-dermatitis syndrome caused by disseminated gonococcal infection -Treatment of gonococcal meningitis and endocarditis Non-gonococcal urethritis and cervicitis: -Immediate-release: 1 g orally once Comment: A 1 g oral dose given once a week for 3 weeks may be effective in the treatment of lymphogranuloma venereum due to Chlamydia trachomatis. 500 mg PO once, then 250 mg once daily for 4 days 2 g extended release suspension PO once 500 mg IV as single dose for at least 2 days; follow with oral therapy with single dose of 500 mg to complete 7-10 days course of therapy Infection of pharynx, cervix, urethra, or rectum: Ceftriaxone 250 mg IM once plus azithromycin 1 g PO once (preferred) or alternatively doxycycline 100 mg PO q12hr for 7 days CDC STD guidelines: MMWR Recomm Rep. June 5, 20(RR3);1-137 Agitation Allergic reaction Anemia Anorexia Candidiasis Chest pain Conjunctivitis Constipation Dermatitis (fungal) Dizziness Eczema Edema Enteritis Facial edema Fatigue Gastritis Headache Hyperkinesia Hypotension Increased cough Insomnia Leukopenia Malaise Melena Mucositis Nervousness Oral candidiasis Pain Palpitations Pharyngitis Pleural effusion Pruritus Pseudomembranous colitis Rash Rhinitis Seizures Somnolence Urticaria Vertigo Anaphylaxis Angioedema Anorexia Bronchospasm Constipation Dermatologic reactions Dyspepsia Elevated liver enzymes Erythema multiforme Flatulence Oral candidiasis Pancreatitis Pseudomembranous colitis Pyloric stenosis, rare reports of tongue discoloration Stevens-Johnson syndrome Torsades de pointes Toxic epidermal necrolysis Vomiting/diarrhea, rarely resulting in dehydration Neutropenia Elevated bilirubin, AST, ALT, BUN, creatinine Alterations in potassium Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Use with caution in abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and hepatic failure have been reported, some of which have resulted in death; discontinue azithromycin immediately if signs and symptoms of hepatitis occur Injection-site reactions can occur with IV route In treatment of gonorrhea or syphilis, perform susceptibility culture tests before initiating azithromycin therapy; may mask or delay symptoms of incubating gonorrhea or syphilis. Bacterial or fungal superinfection may result from prolonged use Prolonged QT interval: Cases of torsades de pointes have been reported during postmarketing surveillance; use with caution in patients with known QT prolongation, history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias, or uncompensated heart failure; also use with caution if coadministering with drugs that prolong QT interval or proarrhythmic conditions (eg, hypokalemia, hypomagnesemia); elderly patients may be more susceptible to drug-associated effects on QT interval Pneumonia: PO azithromycin is safe and effective only for community-acquired pneumonia (CAP) due to C pneumoniae, H influenzae, M pneumoniae, or S pneumoniae Cases of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) reported; despite successful symptomatic treatment of allergic symptoms, when symptomatic therapy was discontinued, allergic symptoms recurred soon thereafter in some patients without further azithromycin exposure; if allergic reaction occurs, the drug should be discontinued and appropriate therapy instituted; physicians should be aware that allergic symptoms may reappear when symptomatic therapy discontinued Endocarditis prophylaxis: Indicated only for high-risk patients, per current AHA guidelines Use caution in renal impairment (Cr Cl Because of the low levels of azithromycin in breastmilk and use in infants in higher doses, it would not be expected to cause adverse effects in breastfed infants (Lact Med; https://nih.gov/newtoxnet/lactmed.htm) Binds to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl t RNA from ribosomes, causing RNA-dependent protein synthesis to arrest; does not affect nucleic acid synthesis Concentrates in phagocytes and fibroblasts, as demonstrated by in vitro incubation techniques; in vivo studies suggest that concentration in phagocytes may contribute to drug distribution to inflamed tissues Y-site: Amikacin, aztreonam, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, ciprofloxacin, clindamycin, droperidol, famotidine, fentanyl, furosemide, gentamicin, imipenem, cilastatin, ketorolac, levofloxacin, morphine, piperacillin-tazobactam, ondansetron(? ), potassium chloride, ticarcillin-clavulanate, tobramycin The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Zithromax, Zmax <strong>azithromycin</strong> dosing, indications, interactions.

Zithromax, Zmax azithromycin dosing, indications, interactions.

Combination treatment with a β-lactam plus a macrolide may improve the outcome for elderly patients with community-acquired pneumonia (CAP). The prognoses and mortality rates for elderly patients with CAP who receive ceftriaxone combined with a 3-day course of azithromycin or a 10-day course of clarithromycin were compared in an open-label, prospective study. Of 896 assessable patients, 220 received clarithromycin and 383 received azithromycin. There were no significant differences between groups with regard to the severity score defined by the Pneumonia Patient Outcomes Research Team (PORT) study group; the incidence of bacteremia was also not significantly different. However, for patients treated with azithromycin, the length of hospital stay was shorter (mean ± SD, 7.4 ± 5 vs. 9.4 ± 7 days; Community-acquired pneumonia (CAP) is the most common infectious disease to cause hospitalization and related mortality, especially among elderly people in developed countries [1]. In some medical publications [2, 3], it has been reported that the outcome for elderly patients (age,65 years) with CAP may improve when a macrolide is combined with a second- or third-generation cephalosporin. If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist. Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects can include: If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room. Don’t take this drug again if you’ve ever had an allergic reaction to it. Disclaimer: Our goal is to provide you with the most relevant and current information.

Duration of Antimicrobial Therapy in Community Acquired <b>Pneumonia</b>
Duration of Antimicrobial Therapy in Community Acquired Pneumonia

Appropriate treatment of CAP is challenging and sometimes limited by. 2 g dose of azithromycin microspheres to that of an extended-release. In an open-label, randomized trial, investigators in Austria compared the same total dose of azithromycin either split over 3 days or given as a.

Azithromycin dose pneumonia
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