Treatment of bronchitis with azithromycin: how many days to take, dosage

Antibiotic macrolide group Azithromycin is classified as a modern antibacterial agent of the new generation. The drug has extensive antimicrobial activity, so doctors prefer to prescribe Azithromycin in bronchitis, complicated by a different kind of bacterial infection. To date, the resistance of pathogenic microorganisms to this antibiotic is minimal, so it is often used without first carrying out bapsides for sensitivity.

Treatment of bronchitis with azithromycin

A number of antibiotics, which are most often chosen for the treatment of acute bronchitis of a bacterial nature, include macrolides, of which Azithromycin is a vivid representative. This drug completely blocks the processes of protein synthesis, without which it is impossible to build microbial RNA.

Azithromycin is active in most pathogens, including anaerobes and aerobes.

Before using Azithromycin in bronchitis, you need to consider that this drug does not affect not only viruses, but also pertussis and paracottus pathogens - such bacteria are called Bordetella. This fact should be taken into account if this antibiotic is prescribed for children who do not have immunity (not vaccinated) against whooping cough.

Azithromycin has many analogues, but among them the most common are such drugs as Flemoxinum, Sumamed, Hemomycin and Azitsin.

Indications of the azithromycin in bronchitis

Azithromycin is indicated as a mono drug in acute bronchitis or bronchiolitis of microbial origin.

In the acute period of chronic bronchitis, Azithromycin, active against the hemophilic rod, can become an alternative antibiotic.

With moderately expressed community-acquired pneumonia, Azithromycin is often chosen as a mono drug.

Also, Azithromycin is used primarily in mycoplasma, chlamydia, legionella, - in the defeat of the respiratory tract.

In complications with Azithromycin, therapy with β-lactam antibiotics can be supplemented.

• Azithromycin in acute bronchitis is never prescribed from the first hours or days after the onset of the disease. Antibiotic is used only if there is an increased risk of complications, for example, the attachment of a purulent infection.
• Azithromycin in chronic bronchitis can indeed be effective: in the chronic course of antibiotic choice, drugs of the penicillin or macrolide group are considered. In severe cases, Azithromycin is used in injections, in light cases it is sufficient to use tablets.
• Azithromycin in obstructive bronchitis is used only after confirmation of the presence of bacterial infection, because the main treatment for obstruction should be aimed at expanding the bronchi, reducing the viscosity of phlegm and removing it from the respiratory tract. If an antibacterial agent is needed, then the choice is made between the antibiotics of the aminopenicillin, fluoroquinolone and macrolide series: therefore, doctors often stop on Azithromycin.

[1], [2],

Release form

Azithromycin is produced in capsular form. One capsule may contain 250 or 500 mg of the active ingredient.

Capsules of 250 mg are distinguished by a lid of red color.

In capsules, 500 mg of the cap is blue.

It is possible to pack three or six capsules in one blister plate packed in a cardboard box.

Titles

Analogs of Azithromycin, which can be used for bronchitis, are the following drugs:

• Azax tablets, Turkish production;
• Indian tablet preparation Asiaggio;
• Azibiot (a preparation of joint production of Poland and Slovenia);
• encapsulated and powdered preparation Ziomycin, Azivok, Zitrocin, Zitrox, Zit-250 or Azin (India);
• Azimed (Kievmedpreparat);
• Azinort (a co-product of the United States and India);
• Sumamed (Israel-Croatia);
• Hemomycin (a Serbian remedy);
• Ormax (Ukraine);
• Zitrolid (Russia);
• Zatrine (Great Britain).

Also, alternative antibiotics for bronchitis are Zybaks, Defens, Arean, Azitsin Darnitsa, Azo, Zimaks, Ziromin, and others.

[3], [4], [5]

Pharmacodynamics

Azithromycin is one of the representatives of antibacterial drugs of macrolide group. The antibiotic is characterized by an extended spectrum of antimicrobial activity, as it affects the staphylococci, streptococci, hemophilic infection, moraecella, bordetella, campylobacteria, legionella, neisheria, gardnerella, bacteroids, peptostreptococci, peptococci, clostridia, chlamydia, mycobacteria, mycoplasma, ureaplasma, spirochetes.

Azithromycin binds to the 50S ribosomal subunit, inhibits peptidranslokase in the translational stage, blocks the biological production of proteins, which generally leads to a slowdown in the growth and development of microbes. If the concentration of the antibiotic allows, then the bactericidal action of the drug may be observed.

[6], [7], [8]

Pharmacokinetics

Azithromycin is resistant to acids, it is well absorbed in the digestive system.

After taking 500 mg, bioavailability is 37%. The limiting concentration content in the serum is observed for 2-3 hours.

The predicted distribution volume is 31.1 liters / kg.

Binding to plasma proteins is inversely proportional to the content in the bloodstream: 7-50%.

The half-life is 68 hours.

Steady content in the serum is found after 5-7 days.

Azithromycin without problems overcomes barriers and is distributed in tissues.

Can be transferred by phagocytes or macrophages to an infectious focus, where it demonstrates its antibacterial effect.

Simultaneous eating reduces the concentration limit values by more than half.

In the liver, the drug loses its activity.

The serum clearance is 630 ml per minute, with almost 60% being excreted in the unmodified form, and 6% with the urinary fluid.

[9], [10], [11], [12]

Dosing and administration

Azithromycin in bronchitis can be prescribed to both adult patients and children weighing 45 kg. The drug is taken orally, 60 minutes before meals, or two hours after it, every day, once a day.

As a rule, with bronchitis Azithromycin is taken according to this scheme:

• the first day - 500 mg of antibiotic;
• from the second to the fifth day - 250 mg.

A short course of Azithromycin is also possible: 500 mg for three days. The total amount of antibiotic per course is 1500 mg.

For elderly patients, as well as for people suffering from a mild failure of renal function, it is not necessary to correct the amount of the drug.

How many days does Azithromycin take with bronchitis?

The duration of the course of Azithromycin in bronchitis depends on which regimen the doctor has prescribed. Standard doctors use two treatment regimens, designed for five days or three days. Longer-term administration is undesirable: the need for it is evaluated by the physician individually.

[20], [21]

Azithromycin in bronchitis in adults

Should I use Azithromycin to treat bronchitis in adults? Not always. Many doctors recommend to apply to antibiotic therapy only when joining a purulent infection.

Indeed, bronchitis often has a viral origin - so the use of an antibiotic in this case can not be appropriate. Often patients "independently" prescribe to themselves various antibacterial drugs, including Azithromycin - while such treatment not only does not eliminate symptoms, but also often aggravates the course of bronchitis.

In what cases is the treatment with Azithromycin really shown in adults?

• Azithromycin is prescribed for elderly patients with acute bronchitis if they have diabetes, heart failure or they are treated with steroids.
• Azithromycin is used to treat exacerbation of chronic bronchitis, as well as purulent complications of acute bronchitis.

In any other cases, there is no pressing need for antibiotics.

[22], [23], [24]

Azithromycin in children with bronchitis

Bronchitis is found in children much more often than in adults. Particularly affected are the children of the first two years of life, as well as children 9-15 years of age.

In children with bronchitis, antibiotics are also often used, but even here their use is not always justified. To date, quite a lot of different studies have already been carried out, which proved that antibiotics for children with acute bronchitis are ineffective. However, there are cases when treatment with Azithromycin is really necessary:

• If the child has a chronic moist cough that does not go away for 14-20 days.
• If the child's condition worsens dramatically: an intense cough with a purulent discharge occurs, the temperature rises, and sweating is observed.

Take Azithromycin, like any other antibiotic, "just in case" or for "security", absolutely not. A well-thought-out decision on the advisability of treating a child with such a drug should be taken by a doctor.

Children under 3 years of age Azithromycin is prescribed as a suspension:

• body weight 15-24 kg - 5 ml of medicine;
• body weight up to 34 kg - 7.5 ml of the drug;
• body weight up to 44 kg - 10 ml of the drug.

Duration of admission Azithromycin in bronchitis in children - from 3 to 5 days.

[25], [26]

Use of the azithromycin in bronchitis during pregnancy

Azithromycin, like many antibiotics for the treatment of bronchitis, should not be taken by pregnant women, nor by patients who breastfeed a baby.

The only exception can be those situations in which the expected benefit of the treatment is higher than the probable danger for the child.

If you can not refuse to take Azithromycin in the lactation period, for the period of treatment, the feeding is stopped.

Contraindications

Azithromycin for bronchitis is not always prescribed, since this medication has contraindications:

• propensity to allergic reaction to drugs of a macrolide group;
• During pregnancy and breastfeeding;
• viral origin of bronchitis.

Caution should be exercised when treating Azithromycin, if the patient suffers from impaired liver or kidney function, if there is ventricular arrhythmia and prolongation of the QT interval.

In some patients, hypersensitivity may occur even after the abolition of the antibiotic, so these patients need to observe and conduct the necessary treatment.

[13], [14]

Side effects of the azithromycin in bronchitis

Azithromycin is a potent antibiotic, so treatment can be accompanied not only by curative, but also by separate undesirable effects. It is necessary to inform the doctor, if such additional symptoms appear:

• vomiting with nausea, diarrhea, increased gassing, darkening of stool, jaundice, emaciation, strong digestive disorders;
• skin rash with itching, swelling, Stevens-Johnson syndrome;
• sensitivity of the skin to ultraviolet, intoxication epidermal necrolysis;
• dizziness, pain in the head, changes in taste, syncope;
• sleep disorders, irritability, anxiety, hyperkinesis;
• decrease in the number of leukocytes, platelets in the blood;
• pain behind the sternum, heart rhythm disturbances;
• fungal infections, kidney damage;
• pain in the joints, impaired hearing function.

Most side effects are rare, but the possibility of their occurrence can not be completely ruled out.

[15], [16], [17], [18], [19]

Overdose

If the patient takes an excessive amount of the antibiotic Azithromycin, then he develops an overdose state, which is characterized by such signs as nausea, transient loss of auditory function, vomiting, indigestion.

If this happens, the patient should be washed the stomach and take a neutralizing agent with aluminum hydroxide or magnesium hydroxide (so-called antacids, or antacids).

[27], [28], [29]

Interactions with other drugs

Anti-acid agents, which include aluminum or magnesium hydroxide, worsen the absorption and reduces the concentration of Azithromycin in the serum. It is necessary to maintain the interval between the use of these drugs at least 180 minutes.

In normal recommended quantities, Azithromycin can affect the kinetic properties of such drugs as Atorvastatin, Carbamazepine, Rifabutin, Theophylline, Cetirizine, Didanosine, Sildenafil, Triazolam, Zidovudine, Flukonazole, etc. Fluconazole, in turn, can moderately affect the kinetic ability of Azithromycin. Nevertheless, it is not necessary to make adjustments to the dosages of the above medicines.

Azithromycin increases the concentration of digoxin in the blood.

Simultaneous reception with such drugs as Ergothamine and Dihydroergotamine can cause the development of peripheral vascular spasm and dysesthesia-type sensitivity disorders.

Influence on the concentration of Azithromycin in the serum of drugs such as Ciclosporin, Phenytoin, Terfenadine and Geksobarbital.

[30], [31], [32], [33]

Storage conditions

Antibiotic is preserved, without removing the packaging, under room conditions - the optimum room temperature should be from +18 to + 25 ° C. Medicines should be kept away from children's access.

[34], [35], [36], [37]

Shelf life

Azithromycin, which is used to treat bronchitis, can be stored for up to 2 years.

[38], [39], [40], [41]

What is better with bronchitis?

Which of the antibiotics is better for treating bronchitis? This question can be answered only by the attending physician who, according to the results of the tests, will see to which medication the pathogen of the disease shows greater sensitivity.

If the doctor runs the risk of prescribing an antibiotic without first examining the bacteriological component of sputum, then antibiotics of a wide range of antibacterial activity become the drugs of choice, to which Azithromycin can also be assigned.

Sometimes the doctor, when prescribing a prescription, indicates two antibacterial drugs "to choose", implying that these medicines have the same pharmacological effect. However, in some patients this approach confounds: which of these drugs is better and more effective?

• Azithromycin or Amoxicillin?  According to the research, both drugs have sufficient efficacy for the treatment of acute bacterial bronchitis. Therefore, if the bacterial analysis demonstrates the same sensitivity of bacteria to the two drugs, there is no particular difference in the choice. If preliminary sputum bacillus was not performed, then the choice of "Amoxicillin or Azithromycin" must be resolved in favor of Azithromycin, since it has a somewhat wider spectrum of antimicrobial activity.
• Azithromycin or Sumamed?  In fact, these are two analog preparations, in fact the active ingredient of Sumamed is the same azithromycin. So what's the difference? First of all, the difference in the manufacturer and in the final cost of the medicine. The efficiency is almost the same.

Regardless of the antibiotic prescribed by the doctor, it is necessary to adhere to the prescribed scheme for its administration. Self-medication with antibacterial agents is indeed very dangerous, although the consequences can develop and not be detected immediately. If the doctor has prescribed Azithromycin for bronchitis, then, most likely, there were good reasons for this: ask the doctor about this, because antibiotic therapy is a serious strain on the body.