Therefore, if azithromycin and P-gp substrates such as digoxin are administered concomitantly, the possibility of elevated serum concentrations of the substrate should be considered. The overall clinical cure rate was 95.7% and 96.1%, and bacteriological eradication rate 90.1% and 94.2% in the 3-day and 5-day groups, respectively. In patients receiving both azithromycin and antacids, the medicinal products should not be taken simultaneously. Norrby SR(1), Quinn J, Rangaraju M, Leroy B. As a consequence of this, RNA-dependent protein synthesis in sensitive organisms is prevented. Skipping doses can increase your risk of infection that is resistant to medication. Uses:-Treatment of gastroenteritis caused by Shigella infection-Treatment of mild to moderate campylobacteriosis We comply with the HONcode standard for trustworthy health information - Ragnar.Norrby@smi.ki.se A pooled analysis of two double-blind, multicentre, Phase III studies compared oral telithromycin 800 mg once-daily for 5 days with penicillin V 500 mg three-times-daily or clarithromycin 250 mg twice-daily for 10 days … Consideration of these findings should be balanced with treatment benefits when prescribing azithromycin.Exacerbations of the symptoms of myasthenia gravis and new onset of myasthenia syndrome have been reported in patients receiving azithromycin therapy (see section 4.8).Safety and efficacy for the prevention or treatment of Mycobacterium avium complex in children have not been established.Azithromycin film-coated tablets are not suitable for treatment of severe infections where a high concentration of the antibiotic in the blood is rapidly needed.Azithromycin is not the first choice for the empiric treatment of infections in areas where the prevalence of resistant isolates is 10% or more (see section 5.1).In areas with a high incidence of erythromycin A resistance, it is especially important to take into consideration the evolution of the pattern of susceptibility to azithromycin and other antibiotics. EUCAST (European Committee on Antimicrobial Susceptibility Testing)The prevalence of acquired resistance may vary geographically and with time for selected species and local information on resistance is desirable, particularly when treating severe infections. No teratogenic effects were observed in animal studies of embryotoxicity in mice and rats. Concomitant use of several medicinal products from the same or related group of antibacterial agents is not recommended.Prolonged cardiac repolarisation and QT interval, imparting a risk of developing cardiac arrhythmia and torsades de pointes, have been seen in treatment with other macrolides including azithromycin (see section 4.8). About 12% of an intravenously administered dose is excreted in the urine unchanged over a period of 3 days; the majority in the first 24 hours. Azithromycin has shown no mutagenic potential in standard laboratory tests: mouse lymphoma assay, human lymphocyte clastogenic assay, and mouse bone marrow clastogenic assay. Therefore as the following situations may lead to an increased risk for ventricular arrhytmias (including torsade de pointes) which can lead to cardiac arrest, azithromycin should be used with caution in patients with ongoing proarrhythmic conditions (especially women and elderly patients) such as patients:- Currently receiving treatment with other active substances known to prolong QT interval such as antiarrhythmics of class IA (quinidine and procainamide) and class III (dofetilide, amiodarone and sotalol), cisapride and terfenadine; antipsychotic agents such as pimozide; antidepressants such as citalopram; and fluoroquinolones such as moxifloxacin and levofloxacin- With electrolyte disturbance, particularly in cases of hypokalaemia and hypomagnesaemia- With clinically relevant bradycardia, cardiac arrhythmia or severe cardiac insufficiency.Epidemiological studies investigating the risk of adverse cardiovascular outcomes with macrolides have shown variable results. Daily Daily and limit physical activity Less than twice a week More than twice a week and less than once a day. Metronidazole 500 mg BID for 7 days OR Gel 0.75% 5G Intravaginally for 5 days OR Clindamycin cream 2% one full applicator (5G) intravaginally bedtime for 7 days . Although a causal relationship has not been established, consideration should be given to the frequency of monitoring prothrombin time when azithromycin is used in patients receiving coumarin-type oral anticoagulants.In a pharmacokinetic study with healthy volunteers that were administered a 500 mg/day oral dose of azithromycin for 3 days and were then administered a single 10 mg/kg oral dose of cyclosporin, the resulting cyclosporin CThere is no evidence of a clinically significant pharmacokinetic interaction when azithromycin and theophylline are co-administered to healthy volunteers.