How Effective Is Azithromycin for Pneumonia?

Azithromycin injection, the indication is applicable to the following infections caused by sensitive pathogenic strains: 1. caused by Chlamydia pneumoniae, Haemophilus influenzae, Legionella pneumoniae, Moraxella catarrhalis, Staphylococcus aureus or pneumococcal chain Community-acquired pneumonia caused by cocci that requires intravenous drip treatment first. 2. Pelvic inflammatory disease caused by chlamydia trachomatis, gonorrhoeae, mycoplasma humanis, which requires intravenous drip treatment first. If anaerobic infection is suspected, antibiotics against anaerobic bacteria should be combined.

Drug Name: Azithromycin injection

Drug type: Prescription drugs, medicines for medical workers' injuries
Use classification: Antibiotics

Azithromycin injection ingredients

The main ingredients of this product are: Azithromycin, its chemical name is 9-deoxy-9a-aza-9a-methyl-9a-erythromycin A.
Its structural formula is:

Molecular formula: C ₃₈ H ₇₂ N ₂ O ₁₂
Molecular weight: 749.00

Azithromycin injection

This product is a colorless or almost colorless clear liquid.

Azithromycin injection indications

This product is suitable for the following infections caused by sensitive pathogenic strains:
1. Community-acquired pneumonia caused by Chlamydia pneumoniae, Haemophilus influenzae, Legionella pneumoniae, Mormonella catarrhalis, Staphylococcus aureus, or Streptococcus pneumoniae, which require intravenous drip treatment first.
2. Pelvic inflammatory disease caused by chlamydia trachomatis, gonorrhoeae, mycoplasma humanis, which requires intravenous drip treatment first. If anaerobic infection is suspected, antibiotics against anaerobic bacteria should be combined.

Azithromycin injection specifications

(1) 2ml: 0.2g (2) 2.5ml: 0.25g (3) 5ml: 0.5g (based on C38H72N2O12)

Azithromycin injection dosage

Add this product to 250ml or 500ml of 0.9% sodium chloride injection or 5% glucose injection, so that the final concentration of azithromycin is 1.0 ~ 2.0mg / ml intravenous drip, the drip time is not less than 60 minutes.
For community-acquired pneumonia, the dosage for adults is 0.5 g each time, once a day for at least 2 consecutive days. Followed by oral azithromycin oral Liu 05g / day, 7 to 10 days of treatment as a course of treatment. The time to switch to oral treatment should be determined by the doctor based on clinical response.
For the treatment of pelvic inflammatory disease, the dosage for adults is 0.5 g each time, once a day or two days later, and azithromycin oral preparations should be changed to 0.25 g, taking 7 days as a course of treatment. The time to switch to oral treatment should be determined by the doctor based on clinical response. If anaerobic infection is suspected, anti-anaerobic drugs should be combined.

Azithromycin injection adverse reactions

1. The common adverse reactions of this product are:
gastrointestinal reactions: diarrhea, nausea, abdominal pain, loose stools, vomiting, etc .;
Local reactions: pain at the injection site, local inflammation, etc .;
skin reactions: rash, pruritus, etc .;
Other reactions: such as anorexia, dizziness, or difficulty breathing.
2. This product can still cause the following reactions:
Digestive system: indigestion, flatulence, oral candidiasis, gastritis, etc .;
Nervous system: headache, drowsiness, etc .;
Allergic reactions: bronchospasm, etc .;
Other reactions: abnormal taste, etc .;
Laboratory tests: Serum ALT, AST, creatinine, LDH, bilirubin, and alkaline phosphatase increased, and leukocyte, neutrophil, and platelet counts decreased.

Azithromycin injection contraindications

Those who are allergic to azithromycin, erythromycin or any other macrolide are contraindicated.

Precautions for Azithromycin Injection

1. Use with caution in patients with liver dysfunction.
2. If allergic reactions (such as angioedema, skin reactions, Stevens-Johnson syndrome and toxic epidermal necrosis, etc.) occur during the medication, the drug should be stopped immediately and appropriate treatment measures should be taken.
3. During the treatment, if the patient has symptoms of diarrhea, consider whether pseudomembranous enteritis has occurred. If the diagnosis is confirmed, appropriate treatment measures should be taken, including maintaining water and electrolyte balance and supplementing protein.
4. The instillation time of this product is not less than 60 minutes, and the concentration of the infusion solution should not be higher than 2.0mg / ml.
5. This product contains ethanol. Use with caution for those allergic to ethanol.

Azithromycin injection for pregnant and lactating women

Use with caution for pregnant and lactating women.

Azithromycin injection for children

The safety of children or patients under 16 years of use of this product is unclear.

Azithromycin injection for the elderly

No detailed research data is currently available.

Azithromycin injection drug interactions

The antacid drugs containing aluminum and magnesium can reduce the peak blood concentration of azithromycin oral preparations, but not the AUC value.
Oral azithromycin did not affect theophylline levels or pharmacokinetics in plasma after a single dose of theophylline intravenously. Given that the macrolides currently used can increase plasma theophylline concentrations, caution should be exercised when using azithromycin and theophylline and monitoring of theophylline levels.
Oral azithromycin does not affect prothrombin time with a single dose of benzylacetone. However, care should be taken when azithromycin and benzylacetone are administered to patients, and the prothrombin time should be monitored. Because in the clinic, the simultaneous use of macrolides and benzylacetone will increase the efficacy of anticoagulants.
When azithromycin is used with the following drugs, it is recommended to observe the patient closely:
Digoxin-Increases digoxin levels.
Ergotamine or Dihydroergotamine-Symptoms of acute ergot toxicity are severe peripheral vasospasm and dullness (sensory pain).
Triazolam-By reducing the degradation of triazolam, the pharmacological effect of triazolam is enhanced.
Cytochrome P450 system metabolizers-increase the levels of carbamazepine, terfenadine, cyclosporine, cyclohexidine, phenytoin, etc. in serum.

Azithromycin injection overdose

No detailed research data is currently available.

Azithromycin injection pharmacology and toxicology

Azithromycin inhibits bacterial protein synthesis by hindering the bacterial transpeptide process. In vitro tests prove that azithromycin has antibacterial effects on a variety of common pathogenic bacteria in the clinic, including: Gram-positive aerobic bacteria: Staphylococcus aureus, Streptococcus pyogenes (group A hemolytic streptococcus), pneumonia (chain) Cocci. Alpha hemolytic streptococci (Streptococcus grass green group) and other streptococci, diphtheria (coryneform) bacteria. This product is cross-resistant to erythromycin-resistant Gram-positive bacteria, including Streptococcus faecalis (enterococcus) and various methicillin-resistant Staphylococcus strains.
Gram-negative aerobic bacteria: Influenza (Hemophilus), Parainfluenza (Hemophilus), Kata (Morella), Acinetobacter, Yersinia, Legionella pneumophila, Pertussis, Parapertussis, Shigella, Maasdella, Vibrio cholerae, Hemolytic paracoccus, Pseudomonas shiga.
The activity of this product against the following Gram-negative bacteria depends on the strain and needs to be determined for sensitivity: Escherichia coli, typhoid (Salmonella), Enterobacter, Hydrophila, Klebsiella. Anaerobic bacteria: Bacteroides fragile, Bacteroides, Perfringens, Digestive streptococcus, Clostridium necrosis, Propionibacterium acnes.
Sexually transmitted disease microorganisms: Treponema pallidum, Neisseria gonorrhoeae, Duke (Haemophilus).
Other microorganisms: including Lyme disease agent, Lyme disease agent, Mycoplasma pneumoniae, Mycoplasma hominis, Ureaplasma urealyticus, Chlamydia trachomatis, Pneumocystis carinii, Mycobacterium Aspergillus, Listeria monocytogenes.
The following Gram-negative bacteria are usually resistant: Proteus, Serratia, Morganella, Pseudomonas aeruginosa (Pseudomonas).

Azithromycin injection pharmacokinetics

According to the 52th edition of the Physician Desk Rererence Information:
Patients with community-acquired pneumonia received an intravenous infusion of azithromycin once a day at 0.5 g each at a concentration of 2 mg / ml for one hour each infusion for two to five consecutive days with an average Cmax of 3.63 ± 1.60 g / ml, Cmin It is 0.20 ± 0.15 g / ml, AUC24- is 9.60 ± 4.80 g · h / ml.
Eighteen healthy volunteers received an intravenous infusion of 1 to 4 g (at a concentration of 1 mg / ml, the infusion time was greater than 2 hours), and their CLT and Vd were 10.18 ml / min / kg and 33.3 L / kg, respectively. If 0.5 g of azithromycin is instilled daily, comparing the plasma pharmacokinetic parameters on the first and fifth days, the results show that Cmax increases by 8%, AUC-24 increases by 61%, and Cmin increases by 3 times.
Twelve healthy volunteers took a single oral dose of 0.5 g of azithromycin, Cmax, Cmin, and AUC at 24 g · h / ml, 0.05 g / ml, and 2.6 g · h / ml. The values of each pharmacokinetic parameter for oral administration were approximately single-dose intravenous drip 3 Hours 38%, 83%, and 52% (that is, Cmax 1.08 g / ml, Cmin 0.06 g / ml, AUC24 is 5.0 g · h / ml).
Following oral azithromycin, the concentration in tissue (or body fluid) and the ratio of tissue (or body fluid) to blood / plasma are listed in the table below:
Azithromycin concentration in an adult after taking two 0.25 g (0.5 g) capsules.

High drug concentration in tissues cannot be used as a basis for judging clinical efficacy. The antibacterial activity of azithromycin is related to pH. Azithromycin is concentrated in the lysosome of the cell. The low pH in the lysosome leads to a decrease in azithromycin activity. However, the widespread distribution of drugs in tissues may be related to clinical activity.
* Samples were obtained 2-4 hours after the first dose.
** Samples were taken 10-12 hours after the first dose.
*** Administered in two doses of 0.25 g each with a 12 hour interval.
**** Samples were obtained 19 hours after a single dose of 0.5 g.
In a study of 12 healthy volunteers using a daily intravenous infusion of 0.5 g (1 mg / ml) for 1 hour, in a study of continuous administration for five days, 11% of the dosage within 24 hours after the first administration Urinary excretion, azithromycin excreted into the urine after the fifth administration is about 14%, which is 6% higher than the urine excretion after azithromycin oral administration. After oral administration, the original drug is mainly excreted by bile.
Azithromycin's serum protein binding rate increased and decreased with the increase of blood concentration. The blood drug concentration was 0.02 g / ml, and the serum protein binding rate was 15%. When the blood concentration was 2 g / ml, the serum protein binding rate was 7%.

Azithromycin injection storage

Keep it tightly closed in a cool and dark place.

Azithromycin injection packaging

(1) Ampoule, 1 / box or 2 / box. (2) Ampoule, 2 pieces / box. (3) Ampoule, 1 pc / box

Azithromycin injection validity period

Two years. ^[1]