Azithromycin in pregnancy

The third-generation macrolide antibiotic Azithromycin may be prescribed by a doctor during pregnancy only in cases of extreme necessity, when its benefits to the health of a pregnant woman do not raise doubts in the doctor, far exceeding the likelihood of a negative impact on the fetus.

Other trade names of this drug: Azithromycin dihydrate, Sumamed, Sumametsin, Azitral, Azitrox, Zitrolit, Hemomycin.

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Indications azithromycin in pregnancy

Azithromycin in the 2nd trimester of pregnancy and Azithromycin in the 3rd trimester of pregnancy are prescribed for serious infectious inflammatory diseases caused by the most common pathogens during pregnancy: Streptococcus pneumoniae and Streptococcus pyogenes, Staphylococcus aureu, Neisseria gonorrhoeae, Gardnerella vaginalis, Chlamydia trachomatis, Mycoplasma pneumoniae, Mycobacterium avium complex, Bacteroides fragilis, Ureaplasma urealyticum, Treponema pallidum, Borrelia burgdorferi, etc.

These diseases include bacterial vaginosis; chlamydia (chlamydial cervicitis); urethritis; endometritis; pelvic inflammatory disease caused by gonococci; pyelonephritis; purulent sinusitis, pharyngitis or tonsillitis; purulent otitis; bacterial pneumonia; scarlet fever; tick-borne borreliosis (Lyme disease), which occurs when bitten by ixodid ticks infected with Borrelia spirochetes.

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Is it possible to take Azithromycin during pregnancy?

Azithromycin is prescribed in the same cases when planning pregnancy, as well as for infected dermatoses and erysipelas.

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Release form

Powder or lyophilisate for the preparation of injection solution, tablets, capsules. Sumamed is also available as a powder for the preparation of a suspension taken orally.

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Pharmacodynamics

The bacteriostatic, and in relation to some infections, bactericidal action of Azithromycin occurs due to binding to the transferase catalysts of the 50S ribosome subunit of microorganisms, as a result of which the order of translocation of RNA chains is disrupted and protein formation is suppressed.

In addition, the active substance azithromycin dihydrate stimulates tissue immune cells, activating the chemoxic reaction of T-leukocytes, neutrophils and phagocytes.

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Pharmacokinetics

Due to its high acid resistance, Azithromycin in tablet form is absorbed quite quickly in the gastrointestinal tract and enters the systemic bloodstream and tissues of the respiratory and urinary tract. After 2.5-3 hours after administration, the concentration of the drug in the plasma reaches a maximum with a bioavailability of about 40%. A feature of macrolides is accumulation in cells and phagocytes damaged by microbes, so Azithromycin does not cause fetotoxic effects during pregnancy.

Moreover, after a course of treatment, the active substance remains at the site of inflammation in a therapeutic concentration for five to six days.

The transformation of the drug occurs in the liver; two-stage excretion is carried out by the kidneys - on the first day after use, on average for 28-40 hours.

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Dosing and administration

During pregnancy, oral administration of antibiotics is preferable to parenteral administration, so Azithromycin is most often prescribed in tablet form (1.5 hours before or after meals).

For inflammatory diseases of the respiratory tract, skin and soft tissues - one tablet (0.5 g) once a day, duration of administration is three days. For genitourinary infections - two tablets of 0.5 g (1 g) once a day.

In case of a bite from an infected tick and borreliosis, two tablets of 0.5 g (1 g) should be taken on the first day, and 0.5 g per day in the following 4 days (the total course of treatment is 5 days).

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Contraindications

It is contraindicated to use Azithromycin in the first trimester of pregnancy, in case of hypersensitivity to macrolide antibiotics, in case of liver and/or kidney failure.

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Side effects azithromycin in pregnancy

Macrolides are not teratogenic antibacterial agents, but side effects of azithromycin during pregnancy may include nausea and diarrhea, abdominal pain, tinnitus and hearing loss, increased heart rate, and allergic skin reactions.

One should also keep in mind such a side effect as vaginal candidiasis (thrush), which occurs quite often when using antibiotics. Suppression of obligate microflora by drugs of this group promotes activation of fungal infection, in particular, Candida albicans fungi.

Overdose

An overdose of Azithromycin leads to increased side effects, and with prolonged overdose, bile stasis and liver inflammation may occur.

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Interactions with other drugs

Azithromycin is not prescribed simultaneously with antacids based on magnesium or aluminum, anticoagulants, hypoglycemic agents and heparin.

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Storage conditions

Storage conditions: at a temperature of +18-25°C.

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Shelf life

Shelf life: 24 months.

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Reviews

Doctors' reviews of the effectiveness of Azithromycin and its broad spectrum of antimicrobial action put this drug in first place among macrolide antibiotics used for pneumonia and purulent tonsillitis, and in second place in the treatment of gonorrhea, chlamydia and mycoplasmosis.