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

The macrolide antibiotic Azithromycin is considered a modern antibacterial agent of the new generation. The drug has extensive antimicrobial activity, so doctors prefer to prescribe Azithromycin for bronchitis complicated by various types of bacterial infections. Today, the resistance of pathogenic microorganisms to this antibiotic is minimal, so it is often used without preliminary bacterial culture for sensitivity.

Treatment of bronchitis with Azithromycin

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

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

Before using Azithromycin for bronchitis, it is necessary to consider that this drug does not act not only on viruses, but also on the causative agents of whooping cough and parakoklyush - such bacteria are called Bordetella. This fact must be taken into account if this antibiotic is prescribed to children who do not have immunity (not vaccinated) against whooping cough.

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

Indications azithromycin for bronchitis.

Azithromycin is indicated as a monotherapy for acute bronchitis or bronchiolitis of microbial origin.

In the acute period of chronic bronchitis, Azithromycin, which is active against Haemophilus influenzae, can become an alternative antibiotic.

In cases of moderate community-acquired pneumonia, Azithromycin is often chosen as a single drug.

Also, Azithromycin is used primarily for mycoplasma, chlamydia, legionella, and respiratory tract infections.

In case of complications, Azithromycin can be supplemented with β-lactam antibiotic therapy.

• Azithromycin for acute bronchitis is never prescribed in the first hours or days from the onset of the disease. The antibiotic is used only if there is an increased risk of complications - for example, the addition of a purulent infection.
• Azithromycin can really be effective in chronic bronchitis: in chronic cases, the antibiotics of choice are penicillin or macrolide drugs. In severe cases, Azithromycin is used in injections; in mild cases, tablets are sufficient.
• Azithromycin is used for obstructive bronchitis only after confirming the presence of a bacterial infection, because the main treatment for obstruction should be aimed at expanding the bronchi, reducing the viscosity of sputum and removing it from the respiratory tract. If an antibacterial agent is needed, the choice is made between aminopenicillin, fluoroquinolone and macrolide antibiotics: therefore, doctors often choose Azithromycin.

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Release form

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

The 250 mg capsules have a red cap.

The 500 mg capsules have a blue cap.

Possible packaging: three or six capsules in one blister pack, packed in a cardboard box.

Names

The following drugs are analogs of Azithromycin that can be used for bronchitis:

• Azaks tablets, Turkish production;
• Indian tablet drug Asiagio;
• Azibiot (a drug jointly produced by Poland and Slovenia);
• encapsulated and powdered preparations Ziomycin, Azivok, Zitrocin, Zitrox, Zit-250 or Azinom (India);
• Azimed (Kievmedpreparat);
• Azinort (a drug jointly produced by the United States and India);
• Sumamed (Israel-Croatia);
• Hemomycin (Serbian remedy);
• Ormax (Ukraine);
• Zitrolide (Russia);
• Zathrin (UK).

Also considered alternative antibiotics for bronchitis are Zybax, Defens, Arean, Azitsin Darnitsa, Azo, Zimaks, Ziromin, etc.

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Pharmacodynamics

Azithromycin is one of the representatives of antibacterial drugs of the macrolide group. The antibiotic has an extended spectrum of antimicrobial activity, as it affects staphylococci, streptococci, hemophilic infection, moraxella, bordetella, campylobacter, legionella, neicheria, gardnerella, bacteroides, peptostreptococci, peptococci, clostridia, chlamydia, mycobacteria, mycoplasma, ureaplasma, spirochetes.

Azithromycin binds to the 50S ribosomal subunit, inhibits peptide translocase at the translation stage, blocks biological production of proteins, which generally slows down the growth and development of microbes. If the concentration of the antibiotic allows, then the bactericidal effect of the drug can be observed.

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Pharmacokinetics

Azithromycin is resistant to acid and is well absorbed in the digestive system.

After taking 500 mg, bioavailability is 37%. The maximum concentration in serum is observed within 2-3 hours.

The predicted distribution volume is 31.1 liters/kg.

Plasma protein binding is inversely proportional to the content in the bloodstream: 7-50%.

The half-life is 68 hours.

Steady-state serum levels are detected after 5-7 days.

Azithromycin easily overcomes barriers and is distributed in tissues.

It can be carried by phagocytes or macrophages to the site of infection, where it demonstrates its antibacterial action.

Simultaneous consumption of food reduces the maximum concentration values by more than half.

In the liver, the drug loses its activity.

Serum clearance is 630 ml per minute, with almost 60% excreted unchanged in feces and 6% in urine.

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Dosing and administration

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

As a rule, for bronchitis, Azithromycin is taken according to the following scheme:

• 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 individuals suffering from mild renal impairment, there is no need to adjust the dosage of the drug.

How many days should I take Azithromycin for bronchitis?

The duration of the Azithromycin course for bronchitis depends on the treatment regimen prescribed by the doctor. Typically, doctors use two treatment regimens, designed for five days or three days. Longer treatment is undesirable: the need for it is assessed by the doctor individually.

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Azithromycin for bronchitis in adults

Should Azithromycin be used to treat bronchitis in adults? Not always. Many doctors recommend using antibiotic therapy only when a purulent infection occurs.

Indeed, bronchitis is most often of viral origin - therefore, the use of antibiotics in such a case may not be appropriate. Often, patients "prescribe" various antibacterial drugs for themselves, including Azithromycin - however, such treatment not only does not eliminate the symptoms, but often worsens the course of bronchitis.

In what cases is Azithromycin treatment really indicated in adults?

• Azithromycin is prescribed to elderly patients with acute bronchitis if they also have diabetes mellitus, heart failure, or are undergoing steroid treatment.
• Azithromycin is used to treat exacerbations of chronic bronchitis, as well as purulent complications of acute bronchitis.

In any other cases, there is no urgent need to use antibiotics.

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Azithromycin for bronchitis in children

Bronchitis is found in children much more often than in adults. Children in the first two years of life, as well as children aged 9-15, are especially susceptible to the disease.

Antibiotics are also often used for bronchitis in children, but their use is not always justified here either. To date, many different studies have been conducted that have proven that antibiotics are ineffective for acute bronchitis in children. However, there are cases when treatment with Azithromycin is really necessary:

• If a child has a chronic wet cough that does not go away within 14-20 days.
• If the child's health suddenly worsens: an intense cough with purulent discharge appears, the temperature rises, and profuse sweating is observed.

Taking Azithromycin, like any other antibiotic, "just in case" or for "safety reasons" is strictly prohibited. A doctor should make a balanced decision about the advisability of treating a child with such a drug.

For children under 3 years of age, Azithromycin is prescribed in the form of a suspension:

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

The duration of taking Azithromycin for bronchitis in children is from 3 to five days.

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Use azithromycin for bronchitis. during pregnancy

Azithromycin, like many antibiotics used to treat bronchitis, should not be taken by pregnant women or breastfeeding patients.

The only exceptions may be situations in which the expected benefit from treatment is greater than the potential danger to the child.

If it is impossible to stop taking Azithromycin during lactation, breastfeeding is stopped for the duration of treatment.

Contraindications

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

• tendency to allergic reactions to macrolide drugs;
• pregnancy and breastfeeding period;
• viral origin of bronchitis.

Caution should be exercised when treating with Azithromycin if the patient suffers from liver or kidney dysfunction, ventricular arrhythmia, or prolongation of the QT interval.

In some patients, hypersensitivity may occur even after discontinuation of the antibiotic, so such patients should be monitored and appropriate treatment measures should be taken.

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Side effects azithromycin for bronchitis.

Azithromycin is a fairly powerful antibiotic, so treatment with it may be accompanied not only by therapeutic effects, but also by certain undesirable effects. It is necessary to inform the doctor if such additional symptoms appear:

• vomiting with nausea, diarrhea, increased gas formation, darkening of stool, jaundice, weight loss, severe digestive disorders;
• itchy skin rash, swelling, Stevens-Johnson syndrome;
• skin sensitivity to ultraviolet radiation, intoxication epidermal necrolysis;
• dizziness, headaches, changes in taste, syncope;
• sleep disturbances, irritability, anxiety, hyperkinesis;
• decrease in the number of leukocytes and platelets in the blood;
• chest pain, irregular heartbeat;
• fungal infections, kidney damage;
• joint pain, hearing impairment.

Most side effects are rare, but their possibility cannot be completely ruled out.

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Overdose

If a patient takes an excessive amount of the antibiotic Azithromycin, he develops an overdose condition, which is characterized by such symptoms as nausea, transient loss of hearing function, vomiting, and indigestion.

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

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Interactions with other drugs

Antacid agents containing aluminum or magnesium hydroxide impair absorption and reduce the serum concentration of Azithromycin. It is necessary to maintain an interval of at least 180 minutes between the use of these drugs.

In the usual recommended doses, Azithromycin can affect the kinetic properties of such drugs as Atorvastatin, Carbamazepine, Rifabutin, Theophylline, Cetirizine, Didanosine, Sildenafil, Triazolam, Zidovudine, Fluconazole, etc. Fluconazole, in turn, can moderately affect the kinetic properties of Azithromycin. However, there is no need to adjust the dosages of the above drugs.

Azithromycin increases the concentration of Digoxin in the blood.

Concomitant use with drugs such as Ergotamine and Dihydroergotamine may cause the development of peripheral vascular spasm and sensory disturbances such as dysesthesia.

The following drugs affect the concentration of Azithromycin in the serum: Cyclosporine, Phenytoin, Terfenadine and Hexobarbital.

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Storage conditions

The antibiotic is stored without removing the packaging, at room temperature - the optimal room temperature should be from +18 to +25°C. Medicines should be stored out of reach of children.

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Shelf life

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

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What is better for bronchitis?

Which antibiotic is best for treating bronchitis? Only the attending physician can answer this question, who will see from the test results to which drug the pathogen is more sensitive.

If a doctor risks prescribing an antibiotic without a preliminary study of the bacteriological component of sputum, then the drugs of choice are broad-spectrum antibiotics, which include Azithromycin.

Sometimes, when writing a prescription, a doctor will indicate two antibacterial agents "to choose from", thereby implying that these medications have the same pharmacological action. However, this approach leaves some patients stumped: which of these drugs is better and more effective?

• Azithromycin or Amoxicillin? According to research, both drugs are effective enough to treat acute bacterial bronchitis. Therefore, if the bacterial culture test shows the same sensitivity of bacteria to both drugs, there is no particular difference in the choice. If preliminary bacterial culture of sputum was not carried out, then the choice of "Amoxicillin or Azithromycin" should be decided in favor of Azithromycin, since it has a slightly broader spectrum of antimicrobial activity.
• Azithromycin or Sumamed? In fact, these are two similar drugs, because the active ingredient of Sumamed is the same azithromycin. So what is the difference? First of all, the difference is in the manufacturer and the final cost of the drug. The effectiveness is almost the same.

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