Azithromycin Dispersible Tablets (DT) represent a significant advancement in antibiotic therapy, offering healthcare professionals and patients a reliable, convenient, and well-tolerated treatment option for a wide spectrum of bacterial infections. As a macrolide antibiotic, it demonstrates potent bacteriostatic activity by inhibiting bacterial protein synthesis. The dispersible tablet formulation enhances patient compliance, particularly in pediatric, geriatric, or dysphagic populations, by allowing administration without the need to swallow whole tablets. This comprehensive profile details the pharmacological characteristics, clinical applications, and essential prescribing information for this important antimicrobial agent.

Features

• Contains azithromycin dihydrate as the active pharmaceutical ingredient
• Dispersible tablet formulation that dissolves rapidly in water
• Available in 250mg and 500mg strengths
• Stable at room temperature with a shelf life of 24 months
• Bioequivalent to conventional azithromycin tablets
• Manufactured under GMP-certified conditions
• Child-resistant packaging available
• Sugar-free formulation option for diabetic patients

Benefits

• Rapid onset of action with quick dispersion and absorption
• Enhanced bioavailability compared to some conventional formulations
• Simplified dosing regimen with once-daily administration
• Improved patient compliance, especially in pediatric and elderly populations
• Broad-spectrum coverage against common respiratory and skin pathogens
• Generally favorable side effect profile compared to other antibiotic classes

Common use

Azithromycin DT is indicated for the treatment of mild to moderate infections caused by susceptible strains of designated microorganisms. Primary indications include community-acquired pneumonia due to Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae. It is equally effective for acute bacterial exacerbations of chronic obstructive pulmonary disease and acute bacterial sinusitis. Dermatological applications include uncomplicated skin and skin structure infections caused by Staphylococcus aureus, Streptococcus pyogenes, or Streptococcus agalactiae. The dispersible formulation is particularly valuable for pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to penicillin. Off-label uses may include certain sexually transmitted infections, though specific formulations are preferred for these indications.

Dosage and direction

Dosage should be individualized based on the type and severity of infection, renal function, and patient characteristics. For most respiratory and skin infections in adults: 500mg as a single dose on day one, followed by 250mg once daily on days 2 through 5. Alternative regimen: 500mg once daily for 3 days. Pediatric dosing is weight-based: 10mg/kg on day one (maximum 500mg), then 5mg/kg on days 2-5 (maximum 250mg). Tablets should be dispersed in at least 50mL of water, stirred, and the entire suspension consumed immediately. Administration should occur either one hour before or two hours after meals for optimal absorption. Complete the full prescribed course even if symptoms improve earlier.

Precautions

Use with caution in patients with hepatic impairment; consider dosage adjustment and monitor liver function. Exercise caution in patients with known QT prolongation, electrolyte imbalances, or those taking other QT-prolonging drugs. Monitor for signs of superinfection or pseudomembranous colitis. Use during pregnancy only if clearly needed (FDA Category B). Azithromycin is excreted in breast milk; consider temporary discontinuation of nursing. In elderly patients, monitor for increased risk of QT prolongation. Patients with myasthenia gravis may experience exacerbation of symptoms. Monitor for hearing impairment, particularly in patients with renal impairment or those receiving high doses.

Contraindications

Hypersensitivity to azithromycin, erythromycin, or any other macrolide antibiotics. Contraindicated in patients with known history of cholestatic jaundice/hepatic dysfunction associated with prior azithromycin use. Not recommended for patients with severe renal impairment (CrCl <10 mL/min). Avoid concurrent administration with ergot derivatives or pimozide. Contraindicated in patients with known QT prolongation or ventricular arrhythmias, including torsades de pointes.

Possible side effect

Common adverse reactions (≥1%) include diarrhea/loose stools (5-10%), nausea (3-5%), abdominal pain (2-3%), and vomiting (1-2%). Less frequent effects include headache, dizziness, and reversible hearing impairment. Serious but rare side effects include QT prolongation, ventricular tachycardia, hepatotoxicity, allergic reactions, and Clostridium difficile-associated diarrhea. Dermatological reactions ranging from mild rash to severe cutaneous adverse reactions may occur. Laboratory abnormalities may include elevated liver enzymes, neutropenia, and elevated serum creatinine.

Drug interaction

Significant interactions occur with antacids containing aluminum or magnesium (reduce azithromycin absorption; separate administration by 2 hours). Increases concentration of warfarin (monitor INR), digoxin, phenytoin, and cyclosporine. Concurrent use with other QT-prolonging agents (antiarrhythmics, antipsychotics, fluoroquinolones) may increase arrhythmia risk. Potentiates effects of ergot derivatives and colchicine. Nelfinavir significantly increases azithromycin levels; consider dose reduction. May enhance effects of oral hypoglycemics and theophylline.

Missed dose

If a dose is missed, take it as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed administration. Maintain the regular dosing schedule and contact the prescribing physician if multiple doses have been missed or if uncertainty exists about proper dosing resumption. Consistent dosing maintains effective antibiotic concentrations for optimal bacterial eradication.

Overdose

Symptoms may include severe nausea, vomiting, diarrhea, and temporary hearing loss. QT prolongation and ventricular arrhythmias may occur in significant overdoses. Management is primarily supportive with ECG monitoring for at least 24 hours. Gastric lavage may be considered if presented soon after ingestion. Hemodialysis is not effective for removal. Specific antidotes are not available; treat arrhythmias with standard antiarrhythmic therapy. Contact poison control center for latest management recommendations.

Storage

Store at controlled room temperature (20-25°C/68-77°F) in original packaging. Protect from moisture and light. Keep blister strips intact until time of use. Once dispersed, the suspension should be used immediately and not stored for later use. Keep out of reach of children and pets. Do not use beyond the expiration date printed on packaging. Do not transfer tablets to other containers as this may compromise stability and child-resistant properties.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment recommendations. The prescribing physician should be aware of the complete patient history and potential drug interactions. Dosage and administration should follow approved prescribing information. Not all possible uses, interactions, or adverse effects are included here. Healthcare providers should reference complete prescribing information before administration.

Reviews

Clinical studies demonstrate azithromycin DT’s efficacy with cure rates of 85-95% for respiratory infections and 88-92% for skin infections. Physicians report high patient satisfaction due to the convenient dosing regimen and improved compliance compared to conventional formulations. Pediatricians particularly value the dispersible format for accurate dosing in children. Some reports note gastrointestinal side effects as the most common reason for discontinuation. Overall, it remains a preferred choice for appropriate infections due to its spectrum of activity, pharmacokinetic profile, and patient acceptance.