Azithromycin Oral Suspension Solution 100 mg/5 mL (15 mL)

Azithromycin oral suspension solution 100 mg/5 mL is a macrolide antibiotic in liquid form which is used in dealing with bacterial infections like Otitis media, pharyngitis/tonsillitis, community-acquired pneumonia, acute bacterial sinusitis. After reconstitution with water, each 5mL contains azithromycin dihydrate equivalent to 100mg azithromycin base. It may contain Azithromycin as an active ingredient that may work by blocking translocation step of protein synthesis.

Key Features

How does Azithromycin Oral Suspension Solution may work?

• It gets absorbed after you drink it, azithromycin is absorbed from the gut.
• It’s drawn to infection sites. White blood cells and tissues like lung, tonsils, and prostate soak it up.
• Azithromycin gets diffuses through the bacterial cell wall.
• It may get binds to the 50S Subunit of the bacterial ribosome., specifically the 23S rRNA.
• This may block the translocation step, here the ribosome can’t move to the next codon. So, bacteria can’t make essential proteins needed to grow and multiply.
• With the bacteria stuck unable to make proteins, your immune systems wipe them out.

Usage

• Respiratory: Otitis media, pharyngitis/tonsillitis, community-acquired pneumonia, acute bacterial sinusitis
• Skin/soft tissue: Uncomplicated infections
• STIs: Chlamydia trachomatis single dose
• Off-label: Traveller’s diarrhea, typhoid, H. pylori regimens, MAC prophylaxis in HIV, pertussis.
• Not for: Viral infections, sore throat without strep confirmation, or colds.

Dosage

• Children 6 months Otitis media, CAP 10mg/kg Day 1, then 5mg/kg Days 2–5 5 days total
• Why suspension used for children, adults who can’t swallow tablets, or NG tube dosing.
• Shake well before each dose. Measure with dosing syringe/cup. Give 1hr before or 2hrs after food for best absorption. Can take with food if stomach upset.

Side effects

• Diarrhea
• Nausea
• Abdominal pain
• Vomiting
• Headache
• Rash
• Dizziness
• Fatigue
• Vaginitis
• Risk if low K/Mg

Interaction

• Antacids like aluminium/magnesium tends to decrease absorption 24%. Separate by 2 hours this interacts adversely.
• QT drugs like amiodarone, sotalol, fluoroquinolones, antipsychotics may increase arrhythmia risk.
• Warfarin interaction may increase the bleeding risk. Need to monitor closely.
• Digoxin/P-gp substrates like Azithro inhibits P-gp may increase digoxin levels
• Increase in cyclosporine levels interacts adversely.
• Nelfinavir increases Azithro levels 2-fold.
• Erythromycin/clarithromycin, minimal CYP3A4 inhibition.

Pharmacokinetics

• Absorption: 37% bioavailable. Tmax = 2–3 hrs fasted, 4 hrs fed.
• Distribution: Huge Vd is approx., 31L/kg. Concentrates in tonsils, lungs, prostate, WBCs. Penetrates intracellular pathogens.
• Protein binding: 7–51% concentration dependent.
• Metabolism: Liver. No significant CYP450 interaction.
• Elimination: Biliary excretion mainly approx., 6% renal. Terminal half-life 68 hours. Gives post-antibiotic effect for 10 days.
• Tissue half-life: Even longer drug persists in tissues well after serum clears.

Precautions

• If you are allergic to azithromycin then it should be avoided.
• If you have known QT prolongation, low potassium, magnesium, slow heart rate, or other QT drugs like amiodarone, sotalol, moxifloxacin, ondansetron, and antipsychotics.
• If you feel irregular heart beat or torsades de pointes then it should be avoided.
• If you are with prior medical conditions like liver disease, Myasthenia, diarrhea then it should be avoided.

Conclusion

Azithromycin oral suspension solution 100 mg/5 mL is an effective macrolide antibiotic in liquid form which is used in dealing with bacterial infections like Otitis media, pharyngitis/tonsillitis, community-acquired pneumonia, acute bacterial sinusitis. After reconstitution with water, each 5mL contains azithromycin dihydrate equivalent to 100mg azithromycin base. It may contain Azithromycin as an active ingredient that may work by blocking translocation step of protein synthesis.  It may show some side effect that may can vary from persona to person so it can be used with doctor consultation to avoid any unwanted interaction.

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