Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
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 such as Hemophilus influenzae, Streptococcus
pneumoniae, Mycoplasma pneumoniae, Staphylococcus aureus, mycobacterium avium,
and many others. 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 production of proteins in humans. It is an
unusual antibiotic in that it stays in the body for quite a while (has a long
half-life), allowing for once a day dosing and for shorter treatment courses for
most infections. The FDA approved azithromycin in November 1991.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 250, 500, and 600 mg. Suspension: 100 mg/ teaspoon,
200 mg/teaspoon, 167 mg/teaspoon or 1 g/packet. Powder for Injection: 500 mg.
STORAGE: Tablets should be stored at room temperature between 15-30°C
(59-86°F). Suspension and solution for injection should be kept between 5-30°C
(41-86°F).
DOSING: Azithromycin (except Zmax) can be taken with or without food, but
food reduces stomach upset. Zmax should be taken on an empty stomach 1 hour
before or 2 hours after a meal since food reduces its absorption. The adult
azithromycin dose is 500-2000 mg in multiple or single doses. 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. Zmax usually is given as a
single 2 gm dose.
DRUG INTERACTIONS: Azithromycin (except Zmax) should 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.
Azithromycin should only be used during pregnancy if 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 which
may occur in fewer than one in twenty persons who receive azithromycin. Rare
side effects include abnormal liver tests, allergic reactions, and nervousness.
Strep throat is a sore throat caused by a bacterium called streptococcus (strep) that can be treated through antibiotics. Common symptoms of strep throat include pinkeye, runny nose, skin rash, cough, hoarseness, diarrhea and more. Complications of untreated strep throat include middle ear infections, meningitis, pneumonia, rheumatic fever, and more.
Impetigo is a contagious skin infection caused by staph and strep bacteria. There are two types of impetigo: non-bullous and bullous. Symptoms of non-bullous impetigo include small blisters on the nose, face, arms, or legs and possibly swollen glands. Bullous impetigo symptoms include blisters in various areas, particularly in the buttocks area. Treatment involves gentle cleansing, removing the crusts of popped blisters, and the application of prescription-strength mupirocin antibiotic ointment.
Whooping cough (pertussis) is highly contagious respiratory infection that is caused by the bacteria Bordetella pertussis. There are an estimated 300,000 plus deaths annually from whooping cough (pertussis). Whopping cough commonly affects infants and young children, but can be prevented with immunization with the vaccine. First stage whooping cough symptoms are a runny nose, sneezing, low-grade fever, a mild cough with the cough gradually becoming more severe. After one to two weeks, the second stage of whooping cough begins.
Cystic fibrosis is a disease of the mucus and sweat glands. Cystic fibrosis is an inherited disease. The outcome of the disease leaves the body malnourished, bulky and fouls smelling stools, vitamin insufficiency, gas, painful or swollen abdomen, infertility, susceptible to heat emergencies, and respiratory failure. There is no cure for cystic fibrosis, treatment of symptoms is used to manage the disease.
Toxoplasmosis (toxo) is a parasitic infection that causes flulike symptoms, swollen lymph nodes, and muscle aches and pains that may last from a few days to several weeks. Toxoplasmosis can be contracted by touching the hands to the mouth after gardening, cleaning a cat's litter box, or anything that came into contact with cat feces. Toxoplasmosis can also be contracted by eating raw or partly cooked meat, especially pork or lamb, or touching the hands to the mouth after contact with raw or undercooked meat.
Group A streptococcal infections are caused by group A streptococcus, a bacteria that causes a variety of health problems, including strep throat, impetigo, cellulitis, erysipelas, and scarlet fever. There are more than 10 million group A strep infections each year.
Rheumatic fever is a disease that sometimes occurs after a group A streptococcal infection of the throat. Symptoms and signs include carditis, polyarthritis, Aschoff bodies, rash, Sydenham's chorea, and fever. Treatment for rheumatic fever involves eliminating the bacteria with penicillin, erythromycin, or azithromycin. Further treatment focuses on alleviating the symptoms brought on by the body's immunologic response to the bacteria.
Travelers should prepare for their trip by visiting their physician to get the proper vaccinations and obtain the necessary medication if they have a medical condition or chronic disease. Diseases that travelers may pick up from contaminated water or food, insect or animal bites, or from other people include malaria, meningococcal meningitis, yellow fever, hepatitis A, typhoid fever, polio, and cholera.
Drug resistance (antimicrobial resistance) is the ability of bacteria, fungi, parasites, and viruses to grow, even in the presence of a drug that would normally kill it (or limit it's growth). Drug resistance is a growing problem, particularly for infections such as MRSA, VRE (vancomycin-resistant enterococci), tuberculosis, HIV, STDs, gonorrhea, flu, pneumonia, malaria, E. coli, salmonella, Campylobacter, which causes diarrhea and gastroenteritis. Learn how to protect yourself from resistance to drugs.
Typhus is a disease caused by Rickettsia bacteria. Symptoms and signs include fever, headache, nausea, vomiting, diarrhea, and rash. Antibiotics are recommended as the treatment for endemic and epidemic typhus infections.
Legionellosis is an infection caused by the Legionella pneumophila bacterium. There are two forms of legionellosis: Pontiac fever and Legionnaires' disease, which is the more severe of the two infections. Symptoms of Pontiac fever include fever, headache, muscle aches, and chills. Symptoms of Legionnaires' disease include cough, chills, fever and sometimes muscle aches, headaches, loss of appetite, diarrhea, and severe pneumonia. While Pontiac fever resolves on its own, Legionnaires' disease must be treated with antibiotics.
Trachoma is an infectious disease caused by the Chlamydia trachomatis bacteria. Symptoms and signs include redness and irritation of the eyes with tearing. Trachoma is diagnosed by examining the eyes and eyelids. Treatment involves a single dose of azithromycin (Zithromax) or the use of topical tetracycline (Achromycin) ointment. Infected individuals should be counseled about sanitation and taught simple cleanliness.
While many people use the terms sore throat, tonsillitis, and strep throat
interchangeably, there are significant clinical differences between these
conditions. Understanding the differences can give patients a better idea of how
and when to be concerned and when to seek advice from a physician.
Strep throat is only one of many possible causes of throat infection and sore
throat. While strep throat is most common in children and adolescents, it can
affect people of all ages.
What causes sore throat?
Sore throat has many causes. The most common causes of sore throat are
infections of the throat and the surrounding structures. Any inflammation or
infection of the pharynx, tonsils, esophagus (the food pipe), or larynx (the top
opening part of the windpipe) may cause sore throat.
What are the tonsils and tonsillitis?
The tonsils are red, oval clumps of tissue locat...
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