Treatment of Major Pathogens of the Respiratory Track: Azithromycin

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Azithromycin is Azithromycin is a macrolide antibiotic active in vitro to treat major pathogens that cause infections of the respiratory tract, other tissues and according to Wilson, Hannon, and Shields, they are: “bacterial infections, acute bacterial sinusitis, otitis media, pneumonia, tonsillitis, or pharyngitis.”(2014) It is manufactured under the trade name such as Azasite, Zithromax, and Zmax. Azithromycin acts by getting in to the 50S ribosomal subunit of susceptible microorganisms and blocked their regular protein making process.
Azithromycin is contraindicated with patient who has an allergy reaction with its components. Beside that, it is also dangerous for patient has history of jaundice and liver disease cause by using this drug in the past. On the other hand, to be safe before taking the drug, patients need to tell their primary MD if they have the following conditions: liver disease, kidney disease, myasthenia gravis, or a heart rhythm disorder. Azithromycin should not be used with digoxin, cyclosporine, phenytoin, dihydroergotamine, and ergotamine because it may increase the toxicity level of those drugs. Food may also reduce its ability to absorb by half of its full potential. Azithromycin needs to be used with caution when dealing with older adult with liver or kidney impairment, gastrointestinal disease, lactation, and children under 6 months old.
On the other hand, according to one study, the ability of macrolide antibiotics class to contraindicate with some of other drugs has been widely known. According to Westphal’s study in 2000: “Macrolides can induce their own hepatic biotransformation into nitrosoalkanes, which later form an inactive CYP3A4-iron-metabolite complexes to prevent the formation of the C...

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...ould reconstitute to the final concentration of 100mg/ml first, then solution must be further dilute into 1mg/ml or 2mg/ml by adding 5ml of the original solution to 500ml or 250ml of normal saline or other compatible solution. It should be administer over 3 hours for 1mg/ml or over 1 hour for 2mg/ml for intermittent administration, and for oral form, it should be one hour before or two hours after meal. Beside that, a key thing to educate patient and family are to minimize direct sunlight during treatment, can only take magnesium or aluminum 2 hours before or after taking this drugs. On the other hand, when giving azithromycin to patient, the nurse should monitor for loose stool or diarrhea, monitor closely for PT and INR with concurrent use of warfarin, and especially report any sign and symptom of hypersensitivity because it can be serious even though it is rare.

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