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Azithromycin

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

By mouth

Azithromycin is used to treat certain bacterial infections in many different parts of the body. This medicine may mask or delay the symptoms of syphilis… Read more

Brand names include: Azithromycin, Zithromax

By injection

Azithromycin injection is used to treat bacterial infections in many different parts of the body. It is also used to prevent Mycobacterium avium complex… Read more

Brand names include: Amerinet Choice Zithromax, Azithromycin Novaplus

Into the eye

Azithromycin ophthalmic (eye) solution is used to treat infections of the eye, such as bacterial conjunctivitis. Azithromycin belongs to a group of medicines… Read more

Brand names include: AzaSite

Drug classes About this
Antibiotic

What works? Research summarized

Evidence reviews

Azithromycin for acute lower respiratory tract infections

We conducted this review to compare azithromycin with amoxycillin or amoxyclav in treating acute lower respiratory tract infections (LRTI).

Azithromycin versus penicillin G benzathine for early syphilis

Syphilis is a complex disease that can involve virtually any organ in the body. The World Health Organization estimates that at least 12 million people are infected with syphilis worldwide. Some early research suggested that azithromycin was superior to benzathine penicillin G in the treatment of early syphilis, and that azithromycin can overcome the disadvantages of penicillin G benzathine. This review of three trials failed to identify a difference between azithromycin and benzathine penicillin G for early syphilis in the odds of cure rate, with the result being too imprecise to confidently rule out the superiority of either treatment option. Although gastrointestinal adverse effects were more common in the participants on azithromycin, than in those given benzathine penicillin G, the difference with benzathine penicillin did not reach statistical significance. More research is required in this area.

Azithromycin is not useful as monotherapy for uncomplicated malaria. In combinations with other antimalarials, it may need to be used at high doses, potentially affecting tolerability.

To help prevent the malaria parasite from developing resistance to antimalarial medicines, the WHO recommends the use of combination therapy, where malaria infections are treated with more than one drug simultaneously. As azithromycin is an antibiotic that also has an effect on the malaria parasite, we assessed its efficacy and tolerability as an antimalarial when used alone or as part of combination therapy with other antimalarials. Our review of studies conducted over the past 14 years suggests that azithromycin is a relatively weak antimalarial whose efficacy depends on the drug dose and the partner drug in the combination therapy. The data suggest that, among adults, the higher doses needed to achieve an acceptable level of treatment success with malaria may be less well tolerated. Unless the ongoing product and dose optimisation process results in a universally efficacious product or identifies a specific niche application that is complementary to the current scala of more efficacious antimalarial combinations, azithromycin's future as an antimalarial does not look promising.

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Summaries for consumers

Azithromycin for acute lower respiratory tract infections

We conducted this review to compare azithromycin with amoxycillin or amoxyclav in treating acute lower respiratory tract infections (LRTI).

Azithromycin versus penicillin G benzathine for early syphilis

Syphilis is a complex disease that can involve virtually any organ in the body. The World Health Organization estimates that at least 12 million people are infected with syphilis worldwide. Some early research suggested that azithromycin was superior to benzathine penicillin G in the treatment of early syphilis, and that azithromycin can overcome the disadvantages of penicillin G benzathine. This review of three trials failed to identify a difference between azithromycin and benzathine penicillin G for early syphilis in the odds of cure rate, with the result being too imprecise to confidently rule out the superiority of either treatment option. Although gastrointestinal adverse effects were more common in the participants on azithromycin, than in those given benzathine penicillin G, the difference with benzathine penicillin did not reach statistical significance. More research is required in this area.

Azithromycin is not useful as monotherapy for uncomplicated malaria. In combinations with other antimalarials, it may need to be used at high doses, potentially affecting tolerability.

To help prevent the malaria parasite from developing resistance to antimalarial medicines, the WHO recommends the use of combination therapy, where malaria infections are treated with more than one drug simultaneously. As azithromycin is an antibiotic that also has an effect on the malaria parasite, we assessed its efficacy and tolerability as an antimalarial when used alone or as part of combination therapy with other antimalarials. Our review of studies conducted over the past 14 years suggests that azithromycin is a relatively weak antimalarial whose efficacy depends on the drug dose and the partner drug in the combination therapy. The data suggest that, among adults, the higher doses needed to achieve an acceptable level of treatment success with malaria may be less well tolerated. Unless the ongoing product and dose optimisation process results in a universally efficacious product or identifies a specific niche application that is complementary to the current scala of more efficacious antimalarial combinations, azithromycin's future as an antimalarial does not look promising.

See all (34)

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