Azithromycin is an antibiotic from the macrolide family, commonly prescribed to treat various bacterial infections such as those of the respiratory or urogenital tracts. Although its effectiveness is recognized, the prescription of this medication must be accompanied by a clear understanding of its potential side effects and contraindications. Proper management of treatments involves knowing what to expect and remaining vigilant for signs that may indicate an adverse reaction. The role of the physician is crucial in ensuring that this treatment is suitable for the health and needs of each patient, taking associated risks into account.

Azithromycin is an antibiotic in the macrolide class, widely used to treat various bacterial infections. Its use is prescribed in specific medical situations, where its effectiveness is acknowledged against sensitive pathogens. This medication is particularly indicated for respiratory infections such as pneumonia, bronchitis, and sore throats, as well as for urogenital infections like chlamydia. However, the prescription of azithromycin must be carried out methodically, considering the needs and health condition of each patient.

Medical Prescription of Azithromycin

The medical prescription of azithromycin is determined by several factors, including the patient’s age, general health status, and the nature of the infection being treated. The antibiotic is often recommended as a first-line treatment for uncomplicated bacterial infections. For example, for bacterial throat infections, the standard treatment generally consists of a dosage of 500 mg on the first day, followed by 250 mg per day for four days.

It is crucial that the prescription is personalized based on the patient’s medical history. Indeed, certain pathologies or ongoing treatments may influence the effectiveness of azithromycin or increase the risk of side effects. Before starting the treatment, the physician should conduct a comprehensive assessment taking into account allergies, chronic illnesses, and medications being taken simultaneously, in order to anticipate any drug interactions.

Side Effects of Azithromycin

Like any medication, azithromycin can cause unwanted effects. These effects vary in terms of frequency and intensity, making monitoring and patient awareness essential. Side effects are generally classified according to their frequency of occurrence:

• Very common effects (more than 10% of patients): diarrhea, abdominal pain, nausea, and flatulence. These disorders are often related to irritation of the gastrointestinal mucosa caused by the medication.
• Common effects (1 to 10% of patients): vomiting, indigestion, headaches, and dizziness. These effects are often transient and related to individual sensitivity of the digestive system.
• Uncommon effects (0.1 to 1%): tinnitus, increased liver enzymes, insomnia, and nervousness. These effects sometimes require medical follow-up, as they may indicate a particular reaction to azithromycin.
• Rare effects (less than 0.1%): severe allergic reactions, prolongation of the QT interval on the electrocardiogram, cardiac rhythm disorders, and severe skin lesions. Although these effects are exceptional, they require immediate medical attention.

It is also important to note that certain associations should be avoided, such as the consumption of alcohol during treatment with azithromycin, as this can exacerbate certain side effects. Similarly, some drug interactions must be carefully monitored, especially with medications that prolong the QT interval.

Contraindications of Azithromycin

The use of azithromycin is contraindicated in certain medical situations. Absolute contraindications include:

• Allergy to macrolides: any previous reaction to azithromycin or another macrolide, such as erythromycin, prohibits the use of this medication.
• History of severe cardiac rhythm disorders: a prolongation of the QT interval on the electrocardiogram may increase the risk of ventricular arrhythmia.
• Severe liver disease: since azithromycin is metabolized by the liver, its use is contraindicated in cases of advanced hepatic insufficiency.

Precautions for use should be taken in less severe, yet concerning cases:

• Renal insufficiency: reduced clearance of the medication may require dosage adjustments.
• Polymedicated elderly patients: the risk of interactions is higher among patients on multiple treatments.
• Preexisting neurological disorders: special attention is required, as cases of drowsiness or confusion have been reported in vulnerable individuals.

When treatment is considered for pregnant or breastfeeding patients, it is essential to weigh the risks and benefits. Studies have not indicated a teratogenic effect in animals, and azithromycin is generally considered usable during pregnancy, but under the supervision of a healthcare professional.

In case of adverse effects occurring during treatment, it is recommended to consult a healthcare professional quickly to evaluate whether the treatment should be continued or adjusted. Patients should be informed of signs to monitor, including sudden skin rashes, palpitations, or severe digestive symptoms, in order to act quickly in case of problems.

FAQ on Medical Prescription, Side Effects, and Contraindications of Azithromycin