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. 1996;4(4):215–220. doi: 10.1155/S1064744996000415

Azithromycin (Zithromax®)

James M McCarty 1,✉
PMCID: PMC2364499  PMID: 18476095

Abstract

Azithromycin (Zithromax®, Pfizer, Inc., New York, NY) is a 15-membered-ring macrolide and the first azalide antibiotic. It is distinguished from other macrolides by its rapid and extensive penetration into intracellular and interstitial tissue compartments, accompanied by prolonged tissue and serum half-lives. Azithromycin shares the gram-positive activity of erythromycin but is more potent against gram-negative organisms. For urethritis and cervicitis caused by Chlamydia trachomatis, azithromycin is effective and well tolerated in a single dose of 1 g, a regimen recommended by the CDC. A 5-day dosage regimen is available for the treatment of community-acquired respiratory-tract and skin and skin-structure infections caused by susceptible organisms. Azithromycin provides short-duration, high-compliance, cost-effective regimens that should improve outcomes.

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Selected References

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  1. Bahal N., Nahata M. C. The new macrolide antibiotics: azithromycin, clarithromycin, dirithromycin, and roxithromycin. Ann Pharmacother. 1992 Jan;26(1):46–55. doi: 10.1177/106002809202600112. [DOI] [PubMed] [Google Scholar]
  2. Barry A. L., Fuchs P. C., Brown S. D. Relative potencies of azithromycin, clarithromycin and five other orally administered antibiotics. J Antimicrob Chemother. 1995 Apr;35(4):552–555. doi: 10.1093/jac/35.4.552. [DOI] [PubMed] [Google Scholar]
  3. Bush M. R., Rosa C. Azithromycin and erythromycin in the treatment of cervical chlamydial infection during pregnancy. Obstet Gynecol. 1994 Jul;84(1):61–63. [PubMed] [Google Scholar]
  4. Davey P., Parker S. Cost effectiveness of once-daily oral antimicrobial therapy. J Clin Pharmacol. 1992 Aug;32(8):706–710. doi: 10.1002/j.1552-4604.1992.tb03873.x. [DOI] [PubMed] [Google Scholar]
  5. Fass R. J. Erythromycin, clarithromycin, and azithromycin: use of frequency distribution curves, scattergrams, and regression analyses to compare in vitro activities and describe cross-resistance. Antimicrob Agents Chemother. 1993 Oct;37(10):2080–2086. doi: 10.1128/aac.37.10.2080. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Felmingham D., Robbins M. J., Sanghrajka M., Leakey A., Ridgway G. L. The in vitro activity of some 14-, 15- and 16- membered macrolides against Staphylococcus spp., Legionella spp., Mycoplasma spp. and Ureaplasma urealyticum. Drugs Exp Clin Res. 1991;17(2):91–99. [PubMed] [Google Scholar]
  7. Foulds G., Shepard R. M., Johnson R. B. The pharmacokinetics of azithromycin in human serum and tissues. J Antimicrob Chemother. 1990 Jan;25 (Suppl A):73–82. doi: 10.1093/jac/25.suppl_a.73. [DOI] [PubMed] [Google Scholar]
  8. Gladue R. P., Bright G. M., Isaacson R. E., Newborg M. F. In vitro and in vivo uptake of azithromycin (CP-62,993) by phagocytic cells: possible mechanism of delivery and release at sites of infection. Antimicrob Agents Chemother. 1989 Mar;33(3):277–282. doi: 10.1128/aac.33.3.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Haddix A. C., Hillis S. D., Kassler W. J. The cost effectiveness of azithromycin for Chlamydia trachomatis infections in women. Sex Transm Dis. 1995 Sep-Oct;22(5):274–280. doi: 10.1097/00007435-199509000-00002. [DOI] [PubMed] [Google Scholar]
  10. Hamilton R. A., Gordon T. Incidence and cost of hospital admissions secondary to drug interactions involving theophylline. Ann Pharmacother. 1992 Dec;26(12):1507–1511. doi: 10.1177/106002809202601202. [DOI] [PubMed] [Google Scholar]
  11. Hardy D. J., Hensey D. M., Beyer J. M., Vojtko C., McDonald E. J., Fernandes P. B. Comparative in vitro activities of new 14-, 15-, and 16-membered macrolides. Antimicrob Agents Chemother. 1988 Nov;32(11):1710–1719. doi: 10.1128/aac.32.11.1710. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Katz B. P., Zwickl B. W., Caine V. A., Jones R. B. Compliance with antibiotic therapy for Chlamydia trachomatis and Neisseria gonorrhoeae. Sex Transm Dis. 1992 Nov-Dec;19(6):351–354. [PubMed] [Google Scholar]
  13. Kinasewitz G., Wood R. G. Azithromycin versus cefaclor in the treatment of acute bacterial pneumonia. Eur J Clin Microbiol Infect Dis. 1991 Oct;10(10):872–877. doi: 10.1007/BF01975846. [DOI] [PubMed] [Google Scholar]
  14. Krohn K. Gynaecological tissue levels of azithromycin. Eur J Clin Microbiol Infect Dis. 1991 Oct;10(10):864–868. doi: 10.1007/BF01975844. [DOI] [PubMed] [Google Scholar]
  15. Levine W. C., Berg A. O., Johnson R. E., Rolfs R. T., Stone K. M., Hook E. W., 3rd, Handsfield H. H., Holmes K. K., Islam M. Q., Piot P. Development of sexually transmitted diseases treatment guidelines, 1993. New methods, recommendations, and research priorities. STD Treatment Guidelines Project Team and Consultants. Sex Transm Dis. 1994 Mar-Apr;21(2 Suppl):S96–101. [PubMed] [Google Scholar]
  16. Magid D., Douglas J. M., Jr, Schwartz J. S. Doxycycline compared with azithromycin for treating women with genital Chlamydia trachomatis infections: an incremental cost-effectiveness analysis. Ann Intern Med. 1996 Feb 15;124(4):389–399. doi: 10.7326/0003-4819-124-4-199602150-00002. [DOI] [PubMed] [Google Scholar]
  17. Majeroni B. A. Chlamydial cervicitis: complications and new treatment options. Am Fam Physician. 1994 Jun;49(8):1825-9, 1832. [PubMed] [Google Scholar]
  18. Mallory S. B. Azithromycin compared with cephalexin in the treatment of skin and skin structure infections. Am J Med. 1991 Sep 12;91(3A):36S–39S. doi: 10.1016/0002-9343(91)90400-r. [DOI] [PubMed] [Google Scholar]
  19. Martin D. H., Mroczkowski T. F., Dalu Z. A., McCarty J., Jones R. B., Hopkins S. J., Johnson R. B. A controlled trial of a single dose of azithromycin for the treatment of chlamydial urethritis and cervicitis. The Azithromycin for Chlamydial Infections Study Group. N Engl J Med. 1992 Sep 24;327(13):921–925. doi: 10.1056/NEJM199209243271304. [DOI] [PubMed] [Google Scholar]
  20. Neu H. C. New macrolide antibiotics: azithromycin and clarithromycin. Ann Intern Med. 1992 Mar 15;116(6):517–519. doi: 10.7326/0003-4819-116-6-517. [DOI] [PubMed] [Google Scholar]
  21. Periti P., Mazzei T., Mini E., Novelli A. Pharmacokinetic drug interactions of macrolides. Clin Pharmacokinet. 1992 Aug;23(2):106–131. doi: 10.2165/00003088-199223020-00004. [DOI] [PubMed] [Google Scholar]
  22. Piscitelli S. C., Danziger L. H., Rodvold K. A. Clarithromycin and azithromycin: new macrolide antibiotics. Clin Pharm. 1992 Feb;11(2):137–152. [PubMed] [Google Scholar]
  23. Pruessner H. T., Hansel N. K., Griffiths M. Diagnosis and treatment of chlamydial infections. Am Fam Physician. 1986 Jul;34(1):81–92. [PubMed] [Google Scholar]
  24. Retsema J., Girard A., Schelkly W., Manousos M., Anderson M., Bright G., Borovoy R., Brennan L., Mason R. Spectrum and mode of action of azithromycin (CP-62,993), a new 15-membered-ring macrolide with improved potency against gram-negative organisms. Antimicrob Agents Chemother. 1987 Dec;31(12):1939–1947. doi: 10.1128/aac.31.12.1939. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Sanders L. L., Jr, Harrison H. R., Washington A. E. Treatment of sexually transmitted chlamydial infections. JAMA. 1986 Apr 4;255(13):1750–1756. [PubMed] [Google Scholar]
  26. Schentag J. J., Ballow C. H. Tissue-directed pharmacokinetics. Am J Med. 1991 Sep 12;91(3A):5S–11S. doi: 10.1016/0002-9343(91)90394-d. [DOI] [PubMed] [Google Scholar]
  27. Scieux C., Bianchi A., Chappey B., Vassias I., Pérol Y. In-vitro activity of azithromycin against Chlamydia trachomatis. J Antimicrob Chemother. 1990 Jan;25 (Suppl A):7–10. doi: 10.1093/jac/25.suppl_a.7. [DOI] [PubMed] [Google Scholar]
  28. Slaney L., Chubb H., Ronald A., Brunham R. In-vitro activity of azithromycin, erythromycin, ciprofloxacin and norfloxacin against Neisseria gonorrhoeae, Haemophilus ducreyi, and Chlamydia trachomatis. J Antimicrob Chemother. 1990 Jan;25 (Suppl A):1–5. doi: 10.1093/jac/25.suppl_a.1. [DOI] [PubMed] [Google Scholar]
  29. Stamm W. E. Azithromycin in the treatment of uncomplicated genital chlamydial infections. Am J Med. 1991 Sep 12;91(3A):19S–22S. doi: 10.1016/0002-9343(91)90396-f. [DOI] [PubMed] [Google Scholar]
  30. Stamm W. E., Hicks C. B., Martin D. H., Leone P., Hook E. W., 3rd, Cooper R. H., Cohen M. S., Batteiger B. E., Workowski K., McCormack W. M. Azithromycin for empirical treatment of the nongonococcal urethritis syndrome in men. A randomized double-blind study. JAMA. 1995 Aug 16;274(7):545–549. [PubMed] [Google Scholar]
  31. Steingrimsson O., Olafsson J. H., Thorarinsson H., Ryan R. W., Johnson R. B., Tilton R. C. Azithromycin in the treatment of sexually transmitted disease. J Antimicrob Chemother. 1990 Jan;25 (Suppl A):109–114. doi: 10.1093/jac/25.suppl_a.109. [DOI] [PubMed] [Google Scholar]
  32. Washington A. E., Katz P. Cost of and payment source for pelvic inflammatory disease. Trends and projections, 1983 through 2000. JAMA. 1991 Nov 13;266(18):2565–2569. [PubMed] [Google Scholar]
  33. Welsh L. E., Gaydos C. A., Quinn T. C. In vitro evaluation of activities of azithromycin, erythromycin, and tetracycline against Chlamydia trachomatis and Chlamydia pneumoniae. Antimicrob Agents Chemother. 1992 Feb;36(2):291–294. doi: 10.1128/aac.36.2.291. [DOI] [PMC free article] [PubMed] [Google Scholar]

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