Indications
Acos treats susceptible bacterial infections in:

• Lower respiratory tract (bronchitis, pneumonia)

• Upper respiratory tract (sinusitis, pharyngitis/tonsillitis)

• Otitis media

• Skin/soft tissue

• Non-gonococcal urethritis/cervicitis (Chlamydia trachomatis)
  রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন

Pharmacology
Azithromycin (acid-stable) achieves higher tissue concentrations (>50× plasma) via phagocyte transport. Its prolonged half-life (68 hr) enables short-course dosing. Excreted primarily unchanged in bile. Binds to 50S ribosomal subunits, inhibiting protein synthesis in susceptible strains:

• Gram-positive: S. aureus, S. agalactiae, S. pneumoniae, S. pyogenes

• Gram-negative: H. influenzae, M. catarrhalis, N. gonorrhoeae

• Atypicals: C. pneumoniae, C. trachomatis, M. pneumoniae

Dosage & Administration
Oral:

• Adults: 500 mg daily × 3 days or 500 mg day 1, then 250 mg days 2–5

• STDs: 1 g single dose or 500 mg day 1 + 250 mg days 2–3

• Children:

  • 6 months: 10 mg/kg daily × 3 days

  • 15–25 kg: 200 mg daily × 3 days

  • 26–35 kg: 300 mg daily × 3 days

  • 36–45 kg: 400 mg daily × 3 days

• Typhoid: 500 mg daily × 7–10 days

IV (Adults only):

• Pneumonia: 500 mg IV daily × ≥2 days, then oral to complete 7–10 days

• PID: 500 mg IV daily × 1–2 days, then 250 mg oral daily to complete 7 days
  *Take oral doses 1 hr before/2 hr after meals. Suspension: Shake powder, add water to mark, shake until mixed.*
  রেজিস্টার্ড চিকিৎসকের পরামর্শ মোতাবেক ঔষধ সেবন করুন

Interaction

• Antacids: Separate dosing by ≥1 hr

• Cyclosporin/Digoxin: Monitor levels

• Ergot derivatives: Contraindicated

• Warfarin: Monitor prothrombin time

• Theophylline: Consider monitoring

Contraindications
Hypersensitivity to azithromycin/macrolides; hepatic impairment; concomitant ergot derivatives.

Side Effects
Generally mild: Nausea, abdominal pain, diarrhea (occasional). Rare: Rash, photosensitivity, transaminase elevation, reversible hearing loss (high/long-term doses).

Pregnancy & Lactation
Category B: Use only if alternatives inadequate. Caution in nursing (excretion unknown).

Precautions

• Severe renal impairment: Use cautiously

• Monitor for angioedema/anaphylaxis

• No impairment of driving ability

Overdose Effects
Nausea, vomiting, diarrhea, hearing loss. Manage with gastric lavage/supportive care.

Therapeutic Class
Macrolide antibiotic

Storage
Dry, light-protected, cool place. Keep from children.

Chemical Structure
Molecular Formula: C₃₈H₇₂N₂O₁₂