AZITHROMYCIN

J Antimicrob Chemother 2002 May;49(5):875-8
A randomized controlled trial of azithromycin versus doxycycline/ciprofloxacin for the syndromic management of sexually transmitted infections in a resource-poor setting
Rustomjee R, Kharsany AB, Connolly CA, Karim SS
Unit for Clinical and Biomedical Tuberculosis Research, Medical Research Council, King George V Hospital, PO Box 19494, Domerton 4015

A randomized controlled trial was carried out to assess the effectiveness of azithromycin versus a standard regimen with doxycycline/ciprofloxacin in the treatment of sexually transmitted infections in a resource-poor environment. Infection with Chlamydia trachomatis was cured in 23/24 (95.8%) of women in the azithromycin arm versus 19/21 (90.5%) in the doxycycline arm (P = 0.6), resulting in three treatment failures. Gonorrhoea was cured in 55/56 (98.2%) women, with one treatment failure in a patient with concomitant C. trachomatis infection. These results indicate that a single oral dose of azithromycin may prove to be a more effective and convenient treatment for sexually transmitted infections in women in a resource-poor environment.

Sex Transm Dis 2002 Aug;29(8):486-90
A randomized, comparative pilot study of azithromycin versus benzathine penicillin G for treatment of early syphilis
Hook EW 3rd, Martin DH, Stephens J, Smith BS, Smith K
University of Alabama at Birmingham School of Medicine and; Jefferson County Department of Health, Birmingham, Alabama 35294-0007, USA.

BACKGROUND: Penicillin is the only medication currently recommended for treatment of early syphilis in non-penicillin-allergic patients. Preliminary data suggest that azithromycin may be effective for syphilis therapy. STUDY DESIGN: This was a randomized, comparative pilot study of intramuscular injections of benzathine penicillin G and two oral azithromycin regimens for treatment of syphilis. METHODS: We randomly assigned patients with early syphilis to treatment with either intramuscular injections of 2.4 million units of benzathine penicillin G or azithromycin administered orally, either as a single 2.0-g dose or as two 2.0-g doses given 1 week apart. Serological response to therapy was evaluated at 3, 6, 9, and 12 months following therapy. Participants whose rapid plasma reagin (RPR) test became nonreactive or whose RPR titer decreased > or =2 dilutions were classified as responding to therapy. When serological tests did not show a response to therapy, the treatment was classified as a failure if RPR titers increased > or =2 dilutions. Nonresponders were those whose serologic titers remained within +/-1 dilution of the initial RPR titer. RESULTS: Cumulative response rates were as follows: benzathine penicillin G, 86% (12 of 14); azithromycin, 2.0-g single dose, 94% (16 of 17); and azithromycin, two 2.0-g doses given 1 week apart, 83% (24 of 29). Therapy failed for one patient treated with benzathine penicillin and one patient treated with the two-dose azithromycin regimen, whereas in six patients the clinical manifestations of infection resolved but there was no serological response. CONCLUSION: Oral therapy with 2.0 g of azithromycin as a single dose or as two doses 1 week apart is a promising alternative to therapy with benzathine penicillin G for syphilis and should be studied further.

GENERIC NAME: azithromycin
BRAND NAME: Zithromax

DRUG CLASS AND MECHANISM: Azithromycin is a semi-synthetic macrolide antibiotic chemically related to erythromycin and clarithromycin (Biaxin). It is effective against a wide variety of bacteria organisms, such as Hemophilus influenzae, Streptococcus pneumoniae, Mycoplasma pneumoniae, Staphylococcus aureus, and mycobacterium avium, and many others. It is unusual in that it stays in the body for quite a while, allowing for once a day dosing and for shorter treatment courses for most infections.

Azithromycin, like all macrolide antibiotics, prevents bacteria from growing by interfering with their ability to make proteins. Due to the differences in the way proteins are made in bacteria and humans, the macrolide antibiotics do not interfere with humans' ability to make proteins.

PREPARATIONS: Capsules (red): 250mg; Suspension: 100 mg/teaspoon; 200 mg/teaspoon.

STORAGE: Capsules should be kept below 30°C (86°F). Suspension should be kept between 5° and 30°C (41° and 86°F).

PRESCRIBED FOR: Azithromycin is effective against susceptible bacteria causing infections of the middle ear, tonsillitis, throat infections, laryngitis, bronchitis, pneumonia, sinuses and. It is also effective against certain sexually transmitted infectious diseases, such as nongonococcal urethritis and cervicitis.

DOSING: Azithromycin should be taken at least one hour before or two hours after meals since it may bind to food and not be absorbed from the intestine. For most infections, azithromycin is taken once daily for a relatively short course of treatment (usually five days). The first dose is often a "double dose," twice as much as the remainder of the doses given. For acute bacterial sinusitis, azithromycin way be taken once daily for three days.

DRUG INTERACTIONS: Unlike erythromycin and clarithromycin, azithromycin is generally considered free of interactions with most other medicines. It is recommended that azithromycin not be taken at the same time as aluminum- or magnesium- based antacids, such as Mylanta or Maalox because antacids will bind the azithromycin and prevent it from being absorbed from the intestine.

PREGNANCY: There are no adequate studies of azithromycin in pregnant women. However, studies in animals suggest no important effects on the fetus. Azithromycin therefore can be used in pregnancy if the physician feels that it is clearly necessary.

NURSING MOTHERS: It is not known if azithromycin is secreted in breast milk.

SIDE EFFECTS: Azithromycin is generally well tolerated. The most common side effects are diarrhea or loose stools, nausea, abdominal pain, and vomiting, each of which may occur in fewer than one in twenty persons who receive azithromycin. Rarer side effects include abnormal liver tests, allergic reactions, and nervousness.

Caution! Before starting to take this medicine, it is vital that you should consult your doctor! Do not use it on your own initiative, without medical advice.
Also, you should read carefully important health information about this drug given here:

my.webmd.com