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Azithromycin: the first azalide antibiotic.

C H Ballow1, G W Amsden

  • 1Clinical Pharmacokinetics Laboratory, Millard Fillmore Hospital, Buffalo, NY 14209.

The Annals of Pharmacotherapy
|October 1, 1992
PubMed
Summary
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Azithromycin, a novel azalide antibiotic, offers an extended spectrum of activity and improved patient compliance for community-acquired infections. Its favorable pharmacokinetic profile and safety make it a valuable option for treating respiratory, skin, and sexually transmitted infections.

Area of Science:

  • Pharmacology and Microbiology
  • Antimicrobial Agents
  • Azalide Antibiotics

Background:

  • Azithromycin is the first antibiotic in the azalide class, a derivative of macrolides.
  • It possesses a unique chemical structure and an extended spectrum of activity compared to traditional macrolides.

Purpose of the Study:

  • To comprehensively review the chemistry, mechanism of action, spectrum of activity, pharmacokinetics, clinical efficacy, safety, drug interactions, and dosage of azithromycin.
  • To evaluate azithromycin's role in treating community-acquired infections, including respiratory tract, skin, and sexually transmitted diseases.

Main Methods:

  • A thorough literature search was conducted using MEDLINE, identifying 77 articles published from 1988 to the present.
  • Evaluation included pharmacokinetic, microbiologic, basic science, and clinical efficacy studies, with a focus on high-quality comparative trials.

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Main Results:

  • Azithromycin exhibits activity against gram-positive, gram-negative, and atypical pathogens.
  • A 5-day azithromycin course is as effective as 7-14 day regimens of other antibiotics for respiratory and skin infections.
  • Single-dose azithromycin effectively treats chlamydial urethritis and cervicitis with a superior adverse-effect profile.

Conclusions:

  • Azithromycin represents a significant advancement in treating community-acquired infections, particularly respiratory tract, skin, and chlamydia-related STIs.
  • Its unique pharmacokinetics and favorable safety profile enhance patient compliance.
  • Azithromycin is poised to become a key therapeutic option in outpatient and emergency settings, with potential future use in immunocompromised patients.