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Updated: May 4, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Azithromycin use in paediatrics: A practical overview

Philippe Ovetchkine, Michael J Rieder,

    Paediatrics & Child Health
    |January 15, 2014
    PubMed

    Insights

    Azithromycin is an antibiotic for pediatric respiratory infections. However, due to resistance concerns, it is generally not recommended for common childhood infections like pharyngitis or otitis media.

    Area of Science:

    • Pediatric infectious diseases
    • Pharmacology
    • Antimicrobial resistance

    Background:

    • Azithromycin is frequently prescribed for pediatric respiratory infections.
    • Recent concerns have emerged regarding its use and the rise of resistant bacteria.

    Purpose of the Study:

    • To review azithromycin therapy for acute respiratory infections in healthy children.
    • To provide recommendations and identify contraindications for its use.

    Main Methods:

    • Consideration of pharmacokinetics and spectrum of activity.
    • Evaluation of bacterial resistance patterns.
    • Review of clinical aspects and practice guidelines.

    Main Results:

    • Azithromycin use is associated with increased pneumococcal resistance.
    • It is generally not recommended for acute pharyngitis, otitis media, or pneumococcal pneumonia in children.
    • Avoidance is advised in patients with a high risk of bacteremia.

    Conclusions:

    • Azithromycin's role in treating common pediatric respiratory infections is limited due to resistance.
    • Judicious use is recommended, with specific contraindications and exceptions noted.

    Keywords:
    AntibioticsInfectionsMacrolidesResistanceTreatment

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