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PubMed1998

Ability of azithromycin in combination with quinine for the elimination of babesial infection in humans.

We report the ability of azithromycin in combination with quinine to eliminate the Babesia infection in a native Taiwanese woman. Failure of elimination of the babesial infection was observed two weeks after treating with standard regimen of oral quinine plus intravenous clindamycin for a 10-day course of therapy. Azithromycin in place of clindamycin was administered for another 10-day course of therapy two months following initial treatment. Clearance of Babesia parasites was observed and verified by hamster inoculation. These results suggest that azithromycin plus quinine should be considered as an alternative therapy for human babesiosis, especially in the failure of treatment with standard regimens.

Animals↗

PubMed2000

A targeted, single-dose azithromycin strategy for trachoma.

OBJECTIVE: To evaluate the impact of treating children with acute trachoma and their contacts with oral azithromycin. DESIGN: Open, uncontrolled, prospective evaluation of a community-based treatment strategy. SETTING: Central Australian semi-desert Aboriginal community (1995-1996). PARTICIPANTS: 216 school- and pre-schoolchildren aged 6 months and up to 15 years. INTERVENTION: All children with acute trachoma and their contacts (co-resident siblings aged between 6 months and 15 years) received single-dose oral azithromycin suspension (20 mg/kg, to a maximum of 1000 mg). MAIN OUTCOME MEASURE: Prevalence of acute trachoma (World Health Organization trachoma diagnostic criteria). RESULTS: Trachoma prevalence at baseline was 42% (71/169) and 55% (18/33) for schoolchildren and pre-schoolchildren, respectively: 103 schoolchildren and 21 pre-schoolchildren, comprising 77 with follicular trachoma and their 47 contacts, were treated with azithromycin over an 8-week period. Acute trachoma prevalence in schoolchildren fell to 22% at 6-8 months (P < 0.0001) and was 31% at 12 months (P < 0.05 compared with baseline). Pre-schoolchildren were followed up for 6 months after treatment, and their trachoma prevalence fell from 55% to 25% (P < 0.05). Further treatment was given to children with trachoma at 12 months, and the point prevalence of trachoma for schoolchildren at 24 months was 34%. CONCLUSIONS: In contrast to mass-treatment strategies, significant reductions in trachoma prevalence at 6 months were achieved by screening 35% of community members (216) and treating 20% (124). The subsequent prevalence increases support the need for more comprehensive treatment programs, including health promotion and efforts to improve living conditions.

Acute Disease↗

PubMedDate not supplied

[The postantibiotic effect of azithromycin on respiratory pathogens].

We assessed the post-antibiotic effect (PAE) of azithromycin against 3 strains of Streptococcus pneumoniae 2 strains of Haemophilus influenzae and 2 strains of Moraxella catarrhalis. The strains were exposed for 2 hours to a concentration of 0.5 mg/l. A stationary phase inoculum of 1 x 10(6)-5 x 10(6) CFU/ml in IsoSensitest Broth with 5% lysed horse blood and 20 mg/l NAD was used and shaken for the duration of the experiment. Antibiotic was neutralised by dilution 1:1000 into pre-warmed medium. [table: see text] In conclusion, even at such low concentration as achieved in serum, azithromycin has a PAE against the respiratory pathogens studied. In our opinion this could allow the use of azithromycin, in the usual regimen even in bacteremic respiratory infections.

Anti-Bacterial Agents↗

PubMed2000

A randomized clinical trial of combinations of artesunate and azithromycin for treatment of uncomplicated Plasmodium falciparum malaria in Thailand.

Recently, a combination of artesunate and mefloquine has proved effective, although is contraindicated in early pregnancy and young children. Azithromycin, a widely used antibiotic and has antimalarial effects, replace mefloquine as a new alternative antimalarial regimen. Two hundred and two uncomplicated falciparum malaria patients were randomly assigned to 1 of 3 regimens. Patients in group I (n = 68) received artesunate 200 mg once daily for 3 days, group II (n = 67) received artesunate 200 mg together with mefloquine 10 mg/kg on the first 2 days and artesunate 200 mg together with mefloquine 5 mg/kg on the third day, and group III (n = 67) received artesunate 200 mg together with azithromycin 50 mg once daily for 3 days. The 28 day cure rates were 44, 98 and 56%, respectively. The median time to recrudescence was significantly longer in group III. In conclusion, a combination of artesunate and azithromycin might be useful in treating children in whom bacterial and malarial infections may be concomitant. However, further work is required in order to enhance its clinical efficacy.

Adolescent↗

PubMed2000

[Control of a school outbreak of serogroup B meningococcal disease by chemoprophylaxis with azithromycin and ciprofloxacin].

OBJECTIVE: To assess the efficacy of azithromycin as a chemoprophylactic agent in meningococcal disease in pre-school aged children, and the safety of ciprofloxacin in children aged 6-16 years old. METHODS: After classic chemoprophylaxis with rifampicin failed to control a school outbreak of meningococcal disease in Cantabria (Spain), a second cycle of chemoprophylaxis was administered in the school. Azithromycin was administered in the nursery level (99 children, aged 3-5 years old) and ciprofloxacin was administered in the primary and secondary levels (795 children, aged 6-16 years old) and in the school's adult personnel (58 persons). The efficacy of chemoprophylaxis was studied through records of cases of meningococcal disease, the mandatory disease reporting system, and the school's absences. The safety of ciprofloxacin was studied using a questionnaire designed to determine the incidence of adverse osteoarticular effects, which was distributed to parents, school personnel and pediatricians within the school's area. RESULTS: The chemoprophylaxis administered controlled the outbreak. We collected 764 questionnaIres (response rate: 89.5 %). The incidence of arthralgia after ciprofloxacin was 0.9% in children and 3.3% in adults. All were mild and self-limiting without specific treatment, except in one patient (in the adult group) in whom arthralgia was present 1 month after prophylactic treatment. However, the arthralgia was so mild that the patient had not consulted her physician. Only three children had sought medical advice for arthralgia. Consequently, the incidence that would have been detected by the Spanish pharmacovigilance system would have been 0.4% in children and 0% in adults. CONCLUSIONS: Azithromycin was effective in controlling the outbreak in children aged between 3 and 5 years. Ciprofloxacin was safe and effective, with no serious or persistent osteoarticular effects in children. The incidence of arthralgia was lower in children than in adults.

Adolescent↗

PubMed2002

A study of the interaction potential of azithromycin and clarithromycin with atorvastatin in healthy volunteers.

Atorvastatin is a common option among the HMG-CoA reductase inhibitors for the treatment of lipid disorders because of its excellent lipid-lowering efficacy and overall safety profile. Although these agents can rarely cause rhabdomyolysis by themselves, macrolides, among other agents, have been demonstrated to increase the likelihood of this via inhibition of CYP metabolism of the lipid agent. This study investigated the potential for azithromycin and clarithromycin to inhibit the metabolism of atorvastatin. Although there was no interaction between azithromycin and atorvastatin, clarithromycin did have a significant effect on atorvastatin pharmacokinetic parameters. When coadministered, clarithromycin raised subject exposure (AUC24) by 82% and peak plasma concentrations by 56%. These data suggest that while azithromycin appears to be safe to coadminister with atorvastatin, clarithromycin should be avoided in patients taking this and similarly metabolized HMG-CoA inhibitors.

Adolescent↗

PubMed2002

Intervention by azithromycin on bleomycin-induced lung injury in rats and its mechanisms.

OBJECTIVE: To study the role of Th1/Th2 balance in the pathogenesis of pulmonary fibrosis and to investigate the therapeutic mechanisms of azithromycin. METHODS: Male wistar rats were randomly divided into three experimental groups: the bleomycin A(5) (BLM) group (BLM group), the azithromycin (AZI) group (AZI group) and the control group. Quantitative analysis of the histopathologic changes was performed by computer gray scan. The expression of IL-10 mRNA and IFN-gamma mRNA was examined by RNase protection assay (RPA). RESULTS: (1) In the BLM group, up-regulation of IL-10 mRNA was stronger than that of IFN-gamma mRNA, resulting in the inversion of the IL-10/IFN-gamma mRNA ratio, a shift from the Th1-like response of IFN-gamma predominance in the control group to the Th2-like response of IL-10 predominance in the BLM group. (2) The oral administration of AZI inhibited the expression of IL-10 and IFN-gamma mRNA; reversed the Th2-like response in the BLM group to the Th1-like response on day 7; and decreased the exudation of inflammatory cells as well as the degree of fibrosis. CONCLUSIONS: (1) At the early stage of fibrosing alveolitis, Th2 domination and the lack of IFN-gamma in the presence of alveolar epithelial and basement membrane injury may promote the development of fibrosis. (2) Azithromycin can inhibit the expression of IL-10 and IFN-gamma, and reverse the Th2-like response in the BLM group to a Th1-like response, and as a result, decrease the inflammatory injury as well as the degree of BLM-induced lung injury in rats.

Animals↗

PubMed2002

Efficacy of azithromycin, praziquantel and mirazid in treatment of cryptosporidiosis in school children.

The study was conducted at a primary school in Abis 8 village. 88 children aged eleven years consented to participate in the present study. After fecal examination, 43 (48.8%) cases were found infected with Cryptosporidium. The mean oocysts number per high power field (HPF) ranged from (1.6-48 oocysts/HPF). Azitbromycin, praziquantel (PZQ) and mirazid were given to 13, 16 and 14 infected children respectively. Three weeks after treatment, azithromycin and praziquantel gave cure rates of 91% and 56.2% respectively with a percent reduction of oocysts in stools of 99% for azithromycin and 71.5% for PZQ. Mirazid was not effective. All the three drugs were well tolerated. It was concluded that azithromycin is highly effective in the treatment of children with cryptosporidiosis: PZQ decreases the infection rate and intensity.

Animals↗

PubMed2000

[Clinical evaluation of azithromycin for respiratory infectious diseases].

Azithromycin(AZM), an azalide macrolide with a 15-membered ring, is superior in cell/tissue penetration. Sustained pulmonary tissue concentrations are maintained which are higher than various MICs for major respiratory pathogens. Much research and clinical investigation has been done to evaluate the clinical efficacy of azithromycin abroad. In Japan, an optimal dose-finding pneumonia study was started in January, 1993, and a controlled comparative pneumonia study with clarithromycin was started in December of the same year. Patient compliance was excellent with the 3-day once daily regimen of AZM(500 mg). Azithromycin has been demonstrated to be highly clinically useful based on high efficacy (including the elderly population) and an established safety profile.

Anti-Bacterial Agents↗

PubMed2000

[Clinical studies of azithromycin, a new macrolide antibiotic, for infections in the field of surgery].

The efficacy of a newly developed macrolide antibiotic, azithromycin, for infections in the field of surgery, was investigated clinically by means of collaborative studies conducted in 17 major institutes and their affiliated hospitals throughout Japan. The following results were obtained. Clinical assessment: Azithromycin was administered at a dose of 250 mg or 500 mg once a day for 3 days. Clinical efficacy was evaluated in 170 patients. These subjects consisted of 81 with superficial purulent diseases, 12 with mastitis, 25 with periproctal abscess, 42 with superficial secondary infection due to trauma, burn and operative wound, 5 with cholecystitis or cholangitis, and 5 with other infections. The clinical efficacy rate was 96.3% (78/81) for superficial purulent diseases, 83.3% (10/12) for mastitis, 84.0%(21/25) for periproctal abscess, and 76.2%(32/42) for superficial secondary infection due to trauma, burn and operative wound. The overall clinical efficacy rate was 88.8%(151/170) respectively. The bacteriological eradication rate was 87.9%(116/132) for gram-positive bacteria, 85.0%(34/40) for gram-negative bacteria, and 100%(63/63) for anaerobic strains of casual bacteria, which were isolated from 140 patients. The overall bacteriological eradication rate was 90.6%(213/235) respectively. Adverse effects were observed in 6 of 170 patients in whom they were evaluated. They consisted of gastrointestinal symptoms in 5 patients and exanthema in 1. Abnormal changes in clinical laboratory test values were observed in 5 patients, and consisted of eosinophilia in 1, elevations of S-GOT and S-GPT in 1, elevations of S-GOT, S-GPT and gamma-GTP in 1, elevation of S-GPT in 1, and elevations of AL-P and gamma-GTP in 1. These results suggest that azithromycin is very useful for surgical infections in the field of surgery.

Abscess↗

PubMed2000

[Clinical safety of azithromycin].

The safety of azithromycin has been assessed in the clinical trial in Japan. Among the patients treated with azithromycin, side effects were recorded in 82(4.35%) of 1,886 adults and in 22(3.03%) of 726 children. The most common side effects in both groups were diarrhea, abdominal pain, and other gastrointestinal symptoms. All side effects were classed as mild or moderate. Laboratory abnormalities were recorded in 125(7.75%) of 1,279 adults and 85(19.23%) of 442 children, which included eosinophilia, neutropenia, and increases of GOT and GPT, and so on. All laboratory abnormalities were not severe and transient. Overall, azithromycin was well tolerated and can be safely used to treat bacterial infections in patients of all ages.

Age Factors↗

PubMed2002

Randomized trial of azithromycin in the prophylaxis of Mediterranean spotted fever.

A randomized clinical trial was undertaken to compare clinical and serologic parameters of the efficacy of one-dose azithromycin in the prophylaxis of Mediterranean spotted fever (MSF) in 122 persons with a tick bite history. Antibodies to Rickettsia conorii (R. conorii) were detected by indirect immunofluorescence (IFA) assay in 55 (45.1%) of 122 subjects. Positive result was obtained in 19 (31.1%) of 61 subjects with azithromycin prophylaxis and in 36 (59.0%) of 61 subjects without prophylaxis. Clinical signs and symptoms of MSF were recorded in 6 (9.8%) and asymptomatic infection in 30 (49.2%) of 61 subjects without prophylaxis. In subjects with prophylaxis, clinical signs of the disease were not recorded at all, whereas asymptomatic infection was detected in 19 (31.1%) of 61 subjects. Based on the results obtained in our study, we assume that a single dose of azithromycin is promising in MSF prevention.

Adult↗

PubMed2003

[Clinic efficacy of treating chronic prostatitis caused by Neisseria gonorrhoeae with azithromycin aspartic-acid injection].

OBJECTIVES: To assess the clinic efficacy of treating chronic prostatitis by Neisseria gonorrhoeae with azithromycin aspartic-acid injection. METHODS: Nineteen cases were treated with monotherapy and once-daily intravenous dosing of azithromycin injection. The effects and side-effects after treatment were observed. RESULTS: Twelve of nineteen cases were cured. CONCLUSIONS: A short term therapy with azithromycin injection for chronic prostatitis caused by Neisseria gonorrhoeae is very effective and easy to used and thus eliminate any problem of compliance.

Adolescent↗

PubMed2004

Azithromycin treatment failures in syphilis infections--San Francisco, California, 2002-2003.

The San Francisco Department of Public Health (SFDPH) is investigating several clinical failures in syphilis patients treated with the macrolide antibiotic azithromycin. This report describes the use of azithromycin for syphilis treatment, recent treatment failures in San Francisco, and CDC recommendations for syphilis treatment. Clinicians should exercise caution in using azithromycin for treating incubating syphilis or syphilis infection until the risk and mechanism of failure are better understood.

Adult↗

PubMed2005

Microbiological assay for the determination of azithromycin in ophthalmic solutions.

The validation of a simple, sensitive and specific agar diffusion bioassay, applying cylinder-plate method, for the determination of the antibiotic azithromycin in ophthalmic solutions is described. Using a strain of Bacillus subtilis ATCC 9372 as the test organism, azithromycin at concentrations ranging from 50.0 to 200.0 microg.mL(-1) could be measured in 1.6667 mg.mL(-1) ophthalmic solutions. A prospective validation of the method showed that the method was linear (r = 0. 999 9) and precise (RSD = 0. 70) and accurate (it measured the added quantities). The results obtained by bioassay method could be statistically calculated by linear parallel model and by means of regression analysis and verified using analysis of variance (ANOVA). We conclude that the microbiological assay is satisfactory for quantification of azithromycin in ophthalmic solutions.

Anti-Bacterial Agents↗

PubMedDate not supplied

Outcome of azithromycin treatment of active trachoma in Omani school children.

A prospective cohort study was made of 386 first-grade primary-school children in Oman with active trachoma and 386 matched controls without trachoma. All children were educated about trachoma prevention. In addition, trachoma cases were treated with a single dose of oral azithromycin (20 mg/kg). Trachoma status was evaluated after 6 weeks, 6 months and 12 months. The follicles and inflammatory signs of active trachoma resolved 6 weeks or more after azithromycin treatment. The protection against subsequent trachoma infection cycles was optimal at 6 months (85.2% of cases, 99.0% of controls infection-free) but declined at 12 months (66.7% of cases, 98.2% of controls infection-free). Clinical evaluation seems to be a useful tool to evaluate the response of azithromycin to active trachoma cases in schoolchildren in a country with limited resources.

Administration, Oral↗

PubMed2006

Degradation studies of azithromycin and its spectrophotometric determination in pharmaceutical dosage forms.

A simple, accurate and rapid spectrophotometric method for the estimation of azithromycin has been developed by the acidic hydrolysis of the drug with sulfuric acid and monitoring the absorbance at 482 nm. All variables affecting the reaction conditions such as sulfuric acid concentration, heating time, temperature and dilution solvents were carefully studied. Analytical parameters such as stability, selectivity, accuracy and precision have been established for the method and evaluated statistically to assess the application of the method. The method was applied successfully for the assay of azithromycin dihydrate in pure and pharmaceutical dosage forms as tablets, capsules and suspensions. The method was found to have the advantages for simplicity, stability, sensitivity, reproducibility and accuracy for using as an alternate to the existing non-spectrophotometric methods for the routine analysis of the drug in pharmaceutical formulations and also in pharmaceutical investigations involving azithromycin dihydrate.

Anti-Bacterial Agents↗

PubMed2006

[Spectrophotometric determination of azithromycin by charge transfer reaction].

The charge transfer interactions of Azithromycin and 7,7,8,8-tetracyanoquinodimethane (TCNQ) or chloranilic acid (CL) were investigated by spectrophotometry. The apparent molar absorptivity of TCNQ complex is 2.7 x 10(4) L x mol(-1) x cm(-1) at 743 nm, and 5.0 x 10(4) L x mol(-1) x cm(-1) at 842 nm; and that of CL complex is 2.4 x 10(3) L x mol(-1) x cm(-1). Beers law is obeyed in the concentration range of 0-30 mg x L(-1) for TCNQ method, and 5-225 mg x L(-1) for CL method. The relative standard deviations of the two methods are 1.0% and 1.4% (n = 6), respectively. The composition of complex of Azithromycin with 7,7,8,8-tetracyanoquinodimethane or chloranilic acid is 1 : 2. This proposed method has been applied to the determination of Azithromycin in tablets with satisfactory results.

Anti-Bacterial Agents↗