Azithromycin

Azithromycin is a macrolide antibiotic medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Certain chest infections, including some pneumonias and bronchitis
• Throat, tonsil, and sinus infections in penicillin-allergic patients
• Some ear infections
• Skin and soft-tissue infections
• Several sexually transmitted infections (e.g. chlamydia)
• Some cases of typhoid or traveller's diarrhoea, per doctor

The dose of Azithromycin depends on the infection but courses are typically short. A common adult regimen is 500 mg once daily for 3 days, or 500 mg on day one followed by 250 mg once daily for 4 more days; some infections use a single larger dose decided by the doctor. Take Azithromycin once a day at about the same time.

Children's doses are based on body weight and must be set by a doctor. Even though the course is short, take every dose and finish it completely — a short course does not mean you can stop the moment you feel better.

Azithromycin is generally well tolerated. Possible side effects include:

• Nausea, vomiting, diarrhoea, or stomach pain
• Headache or dizziness
• Altered taste
• Temporary changes in liver enzymes

Rarely, macrolides can affect the heart's rhythm (QT prolongation), causing palpitations or fainting, and can cause serious allergic or skin reactions. Seek urgent care for a fast or irregular heartbeat, fainting, severe diarrhoea, or signs of an allergic reaction while taking Azithromycin.

Azithromycin is a prescription-only antibiotic — never self-medicate. Azithromycin is one of the most overused and misused antibiotics in Bangladesh, frequently taken for ordinary colds, coughs, and fevers where it does nothing but breed resistance. Take it only when a registered doctor prescribes it, and never buy it over the counter for viral illnesses.

Always complete the full course even though it is short and you feel better quickly. Tell your doctor about any heart-rhythm problems or medicines that affect the heart. Antibiotic resistance is a serious national crisis in Bangladesh, and azithromycin misuse is a leading cause.

Tell your doctor about all your medicines. Important interactions with Azithromycin include:

• Antacids containing aluminium or magnesium — separate by at least 2 hours
• Other QT-prolonging drugs (some heart, anti-nausea, and antipsychotic medicines) — added heart-rhythm risk
• Warfarin — bleeding risk may increase
• Digoxin, colchicine, ciclosporin — levels can rise
• Certain ergot medicines

Do not take Azithromycin if you:

• Are allergic to azithromycin or other macrolide antibiotics (such as erythromycin or clarithromycin)
• Have had liver problems or jaundice caused by azithromycin before

It is used with great caution in people with a known heart-rhythm disorder (long QT), very slow heart rate, low potassium or magnesium, or significant liver disease. Always share your full history with your doctor.

Azithromycin may be used in pregnancy when the doctor judges it necessary and a suitable choice for the infection. Tell your doctor if you are pregnant or planning a pregnancy so the decision can be made carefully.

Small amounts pass into breast milk; it is often considered compatible with breastfeeding, but the baby should be watched for loose stools or thrush. Always discuss breastfeeding with your doctor before starting Azithromycin.

Store Azithromycin in a cool, dry place below 30°C, away from direct sunlight and moisture, in its original packaging. Reconstituted suspension for children should be used within the time stated on the label. Keep all forms out of the reach of children, and do not use the medicine after its expiry date.