Drug Database: Azithromycin

What is azithromycin?

Azithromycin is an antibacterial prescription medicine approved by the U.S. Food and Drug Administration (FDA) for the treatment of certain bacterial infections, such as:

• Various bacterial respiratory diseases, including community-acquired pneumonia, acute sinus and ear infections, acute worsening of chronic bronchitis, and throat and tonsil infections
• Pelvic inflammatory disease
• Genital ulcer disease and infections of the urethra and cervix
• Infections of the skin

Community-acquired pneumonia, a bacterial respiratory disease, can be an opportunistic infection (OI) of HIV. An OI is an infection that occurs more frequently or is more severe in people with weakened immune systems—such as people with HIV—than in people with healthy immune systems. To learn more about OIs, read the HIVinfo What is an Opportunistic Infection? fact sheet.

How is azithromycin used in people with HIV?

The Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV and the Guidelines for the Prevention and Treatment of Opportunistic Infections in Children with and Exposed to HIV include recommendations on the uses of azithromycin in people with HIV to:

Treat:

• Community-acquired pneumonia
• Toxoplasma gondii encephalitis
• Disseminated Mycobacterium avium complex (MAC) infection
• Bacterial enteric infections, including campylobacteriosis and shigellosis
• Certain Bartonella infections (also called bartonellosis), such as infections of the bloodstream (bacteremia) and bone (osteomyelitis)
• Syphilis

• Bacterial enteric infections from occurring the first time
• Disseminated MAC infection from occurring the first time and from recurring
• Syphilis from occurring the first time

The recommended uses may not always be consistent with FDA-approved uses of azithromycin. See the Adult and Pediatric Opportunistic Infection Guidelines for complete information on recommended uses of azithromycin in adults and children with HIV. Azithromycin may have other recommended uses not listed above.

What should I tell my health care provider before using azithromycin?

Before using azithromycin, tell your health care provider:

• If you are allergic to azithromycin or any other medicines.
• About any medical conditions you have or have had, including the following:
  • Pneumonia
  • Cystic fibrosis
  • Myasthenia gravis (a disease that causes muscle weakness)
  • A known or suspected bacteremia (bacterial infection in the blood)
  • Heart problems or an irregular heartbeat, especially a problem called "QT prolongation"
  • Low potassium or low magnesium
  • Kidney or liver problems
• About anything that could affect your ability to take medicines, such as difficulty swallowing pills, difficulty remembering to take pills, or any health conditions that may prevent your use of intravenous medicines.
• If you are pregnant or plan to become pregnant. Talk to your health care provider about the risks and benefits of using azithromycin during pregnancy. The Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV may include other recommendations on the use of azithromycin during pregnancy. Please refer to these guidelines for additional information.
• If you are breast/chestfeeding or plan to breast/chestfeed. For people with HIV in the United States, the Guideline recommends speaking with your health care provider to discuss options for feeding your baby. People with suppressed viral load have a less than 1% chance of transmitting HIV to their baby via their own milk.
• About other prescription and nonprescription medicines, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Azithromycin may affect the way other medicines or products work, and other medicines or products may affect how azithromycin works. Ask your health care provider if there are interactions between azithromycin and the other medicines you take.

Ask your health care provider about possible side effects from azithromycin. Your health care provider will tell you what to do if you have side effects.

How should I use azithromycin?

Use azithromycin according to your health care provider’s instructions. Your health care provider will tell you how much azithromycin to use and when to use it. Before you start azithromycin and each time you get a refill, read any printed information that comes with your medicine.

How should azithromycin be stored?

• Store vials of azithromycin for injection below 86°F (30°C). Once the injection powder in the vial has been reconstituted with sterile water and diluted, it is stable for 24 hours at or below 86°F (30°C), or for 7 days if refrigerated at 41°F (5°C).
• Store azithromycin dry powder for oral suspension below 86°F (30°C). After mixing, store the suspension between 41°F to 86°F (5°C to 30°C). Keep the oral suspension in a tightly closed container.
• Store azithromycin tablets between 59°F and 86°F (15°C to 30°C).
• Do not use azithromycin if the original seal over the container opening is broken or missing.
• Throw away azithromycin that is no longer needed or expired (out of date). Follow FDA guidelines on how to safely dispose of unused medicine.
• Keep azithromycin and all medicines out of reach of children.

Where can I find more information about azithromycin?

• Recommendations on the HIV-related uses of azithromycin, from the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV and the Guidelines for the Prevention and Treatment of Opportunistic Infections in Children with and Exposed to HIV.
• This Patient Version drug summary is based on the following FDA label(s): Injection (powder, lyophilized, for solution); Powder (for suspension), tablet (film coated). The Patient Information section of the label includes information for people using azithromycin.
• The American Hospital Formulary Service (AHFS) Patient Medication Information for azithromycin available from MedlinePlus.
• Azithromycin-related research studies, from ClinicalTrials.gov. (The ClinicalTrials.gov search can be modified so that you can get results that better match your interests. To learn more about the ClinicalTrials.gov search features, please see How to Search.)