Azithromycin

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Pharmachologic effect

Antibiotic group macrolides, is a representative of azalides. Has a wide spectrum of antimicrobial action. The mechanism of action of azithromycin is associated with the suppression of protein synthesis of a microbial cell. Linking to the 50S subunit of ribosomes, inhibits peptidranslokase at the stage of translation, inhibits protein synthesis, slows the growth and multiplication of bacteria. It acts bacteriostatically. In high concentrations has a bactericidal effect.
It has activity against a number of gram-positive, gram-negative, anaerobic, intracellular and other microorganisms.
Gram-positive cocci are sensitive to azithromycin: Streptococcus pneumoniae (penicillin-sensitive strains), Streptococcus pyogenes, Staphylococcus aureus (methicillin-sensitive strains); aerobic gram-negative bacteria: Haemophilus influenzae, Haemophilus parainfluenzae, Legionella pneumophila, Moraxella catarrhalis, Pasteurella multocida, Neisseria gonorrhoeae; some anaerobic microorganisms: Clostridium perfringens, Fusobacterium spp., Prevotella spp., Porphyriomonas spp .; as well as Chlamydia trachomatis, Chlamydia pneumoniae, Chlamydia psittaci, Mycoplasma pneumoniae, Mycoplasma hominis, Borrelia burgdorferi.

Contraindications

Hypersensitivity to azithromycin, erythromycin, other macrolides or ketolides; hypersensitivity to the excipients of the drug used; severe liver dysfunction; severe renal dysfunction (CK <40 mL / min); simultaneous use with ergotamine and dihydroergotamine; children under 18 years (for IV infusions).
With caution: myasthenia gravis; mild to moderate liver dysfunction; mild and moderate renal dysfunction (CK> 40 ml / min); patients with the presence of pro-arrhythmic factors (especially in old age) with congenital or acquired prolongation of the QT interval, patients receiving antiarrhythmic drugs of classes IA (quinidine, procainamide) and III (dofetilide, amiodarone and sotalol), cisapride, terfenadine, antipsychotic drugs pimozide), antidepressants (citalopram), fluoroquinolones (moxifloxacin and levofloxacin), with disturbances of the water-electrolyte balance, especially with hypokalemia or hypomagnesemia, with clinically significant bradycardia, arrhythmias her or with severe heart failure; simultaneous use of digoxin, warfarin, cyclosporine.

Side effects

Infectious diseases: infrequently – candidiasis (including mucous membrane of the oral cavity and genitals), pneumonia, pharyngitis, gastroenteritis, respiratory diseases, rhinitis; an unknown frequency is pseudomembranous colitis.
From the blood and lymphatic system: infrequently – leukopenia, neutropenia, eosinophilia; very rarely – thrombocytopenia, hemolytic anemia.
From the metabolism: infrequently – anorexia.
Allergic reactions: infrequently – angioedema, hypersensitivity reaction; an unknown frequency is an anaphylactic reaction.
From the nervous system: often – headache; infrequently – dizziness, dyspnoea, paresthesia, drowsiness, insomnia, nervousness; rarely – agitation; unknown frequency – hypesthesia, anxiety, aggression, fainting, convulsions, psychomotor hyperactivity, loss of smell, perversion of smell, loss of taste sensations, myasthenia gravis, delirium, hallucinations.
From the side of the organ of vision: infrequently – impaired vision.
From the side of the hearing organ and labyrinthine disturbances: infrequently – hearing disorder, vertigo; unknown frequency – hearing impairment up to deafness and / or tinnitus.
From the side of the cardiovascular system: infrequently – a feeling of palpitations, flushes of blood to the face; unknown frequency – a decrease in blood pressure, an increase in the QT interval on the ECG, arrhythmia such as “pirouette”, ventricular tachycardia.
From the respiratory system: infrequently – shortness of breath, nosebleed.
From the digestive system: very often – diarrhea; often – nausea, vomiting, abdominal pain; infrequent – meteorism, dyspepsia, constipation, gastritis, dysphagia, bloating, dryness of the oral mucosa, belching, ulcers of the oral mucosa, increased secretion of the salivary glands; very rarely – a discoloration of the tongue, pancreatitis.
From the liver and biliary tract: infrequently – hepatitis; rarely – a violation of the liver, cholestatic jaundice; unknown frequency – hepatic insufficiency (in rare cases with a fatal outcome mainly on the background of severe impairment of liver function), liver necrosis, fulminant hepatitis.
From the skin and subcutaneous tissues: infrequently – skin rash, itching, hives, dermatitis, dry skin, sweating; rarely – the reaction of photosensitization; unknown frequency – Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme.
On the part of the musculoskeletal system: infrequently – osteoarthritis, myalgia, back pain, neck pain; unknown frequency – arthralgia.
From the side of the kidneys and urinary tract: infrequently – dysuria, pain in the kidneys; unknown frequency – interstitial nephritis,