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Acute bacterial exacerbations of chronic obstructive pulmonary disease due to Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae. Acute bacterial sinusitis due to Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae, Zithromax 1000 mg Prix Suisse.
Community -acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae or Streptococcus pneumoniae in patients appropriate for oral therapy, Zithromax 1000 mg Prix Suisse. Azithromycin should not be used in patients with pneumonia who are judged to be inappropriate for oral therapy because of moderate to severe illness or risk factors such as any of the following: Penicillin by the intramuscular route is the usual drug of choice in the treatment of Streptococcus pyogenes infection and the prophylaxis of rheumatic fever.
Data establishing efficacy of azithromycin in subsequent prevention of rheumatic fever are not available. Uncomplicated skin and skin structure infections due to Staphylococcus aureus, Streptococcus pyogenesor Streptococcus agalactiae. Abscesses usually require surgical Zithromax 1000 mg prix Suisse. Urethritis and cervicitis due to Chlamydia trachomatis or Neisseria gonorrhoeae.
Genital ulcer disease in men due to Haemophilus ducreyi chancroid. Due to the small number of women included in clinical trials, the efficacy of azithromycin in the treatment of chancroid in women has not been established.
Antimicrobial agents used in high doses for short periods of time to treat non-gonococcal urethritis may mask or delay the symptoms of incubating syphilis.
All patients with sexually-transmitted urethritis or cervicitis should have a serologic test for syphilis and appropriate cultures for gonorrhea performed at the time of diagnosis.
Appropriate Zithromax 1000 mg prix Suisse therapy and follow-up tests for these diseases should be initiated if infection is confirmed. Appropriate culture and susceptibility tests should be performed before treatment to determine the causative organism and its susceptibility to azithromycin. Therapy with ZITHROMAX may be initiated before results of these tests are known; once the results become available, antimicrobial therapy should be adjusted accordingly.
When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy.
In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Acute otitis media caused by Haemophilus influenzae, Moraxella catarrhalis or Streptococcus pneumoniae.
Community-acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae or Streptococcus pneumoniae in patients appropriate for oral therapy. Azithromycin should not be used in pediatric patients with pneumonia who are judged to be inappropriate for oral therapy because of moderate to severe illness or risk factors such as any of the following: Warnings Serious allergic reactions, including angioedema, anaphylaxis, and dermatologic reactions including Stevens Johnson Syndrome and toxic epidermal necrolysis have been reported rarely in patients on azithromycin therapy.
Although rare, fatalities have been reported. Despite initially successful symptomatic treatment of the allergic symptoms, when symptomatic therapy was discontinued, the allergic symptoms recurred soon thereafter in some patients without further azithromycin exposure. These patients required prolonged periods of observation and symptomatic treatment.
The relationship of these episodes to the long tissue half-life of azithromycin and subsequent prolonged exposure to antigen is unknown at present. If an allergic reaction occurs, the Zithromax 1000 mg prix Suisse should be discontinued and appropriate therapy should be instituted. Physicians should be aware that reappearance of the allergic symptoms may occur when symptomatic therapy is discontinued. In the treatment of pneumonia, azithromycin has only been shown to be safe and effective in the treatment of community-acquired pneumonia due to Chlamydia pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae or Streptococcus pneumoniae in patients appropriate for oral therapy.
Pseudomembranous colitis has been reported with nearly all antibacterial agents and may range in severity from mild to life-threatening. Therefore, it is important to consider this Zithromax 1000 mg prix Suisse in patients who present with diarrhea subsequent to the administration of antibacterial agents.
Treatment with antibacterial agents alters the normal flora of the colon and may permit overgrowth of clostridia. Studies indicate that a toxin produced by Clostridium difficile is a primary Zithromax 1000 mg prix Suisse of «antibiotic-associated colitis. Mild cases of pseudomembranous colitis usually respond to discontinuation of the drug alone.
In moderate to severe cases, consideration should be given to management with fluids and electrolytes, protein supplementation, and treatment with an antibacterial drug clinically effective against Clostridium difficile colitis. Because azithromycin is principally eliminated via the liver, caution should be exercised when azithromycin is administered to patients with impaired hepatic function.
Prolonged cardiac repolarization and QT interval, imparting a risk of developing cardiac arrhythmia and torsades de pointeshave been seen in treatment with other macrolides. A similar effect with azithromycin cannot be completely ruled out in Zithromax 1000 mg prixes Suisse at increased risk for prolonged cardiac repolarization.
Prescribing ZITHROMAX azithromycin in the absence of a proven or strongly suspected bacterial infection or a prophylactic indication is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Patients should also be cautioned not to take aluminum- and magnesium-containing antacids and azithromycin simultaneously.
The patient should be directed to discontinue azithromycin immediately and contact a physician if any signs of an allergic reaction occur. They do not treat viral infections e. When ZITHROMAX azithromycin is prescribed to treat a bacterial infection, patients should be told that although it is common to feel better early in the course of the therapy, the medication should be taken exactly as directed.
Skipping doses or not completing the full course of therapy may 1 decrease the effectiveness of the immediate treatment and 2 increase the likelihood that bacteria will develop resistance and will not be treatable by ZITHROMAX azithromycin or other antibacterial drugs in the future.
Co-administration of nelfinavir at steady-state with a single oral dose of azithromycin resulted in increased azithromycin serum concentrations. Although a dose adjustment of azithromycin is not recommended when administered in Zithromax 1000 mg prix Suisse with nelfinavir, close monitoring for known side effects of azithromycin, such as liver enzyme abnormalities and hearing impairment, is warranted.
Azithromycin did not affect the prothrombin time response to a single dose of warfarin, Zithromax 1000 mg Prix Suisse. However, prudent medical practice dictates careful monitoring of Zithromax 1000 mg prix Suisse time in all patients treated with azithromycin and warfarin concomitantly.
Concurrent use of macrolides and warfarin in clinical practice has been associated with increased anticoagulant effects. Drug interaction studies were performed with azithromycin and other drugs likely to be co-administered. Co-administration with efavirenz, or fluconazole had a modest effect on the pharmacokinetics of azithromycin.
No dosage adjustment of either drug is recommended when azithromycin is coadministered with any of the above agents. Interactions with the drugs listed below have not been reported in clinical trials with azithromycin; however, no specific drug interaction studies have been performed to evaluate potential drug-drug interaction.
Nonetheless, they have been observed with macrolide products. Until further data are developed regarding drug interactions when azithromycin and these drugs are used concomitantly, careful monitoring of patients is advised: Ergotamine or dihydroergotamine-acute ergot toxicity characterized by severe peripheral vasospasm and dysesthesia.
Terfenadine, cyclosporine, hexobarbital and phenytoin concentrations. There are no reported laboratory test interactions. Carcinogenesis, Mutagenesis, Impairment of Fertility: Long-term Zithromax 1000 mg prixes Suisse in animals have not been performed to evaluate carcinogenic potential. Azithromycin has shown no mutagenic potential in standard laboratory tests: No evidence of impaired fertility due to azithromycin was found.
Reproduction studies have been performed in rats and mice at doses up to moderately maternally toxic dose concentrations i.
In the animal studies, no evidence of harm to the fetus due to azithromycin was found. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, azithromycin should be used during pregnancy only if clearly needed. It is not known whether azithromycin is excreted in human milk, Zithromax 1000 mg Prix Suisse. Because many drugs are excreted in human milk, caution should be exercised when azithromycin is administered to a Zithromax 1000 mg prix Suisse woman.
Acute Otitis Media total dosage regimen: Safety and effectiveness in the treatment of pediatric patients with otitis media under 6 months of age have not been established. Acute Bacterial Sinusitis dosage regimen: Safety and effectiveness in the treatment of pediatric patients with acute bacterial sinusitis under 6 months of age have not been established.
Use of Zithromax for the treatment of acute bacterial sinusitis pediatric patients 6 months of age or greater is supported by adequate and well-controlled studies in adults, similar pathophysiology of acute sinusitis in adults and pediatric patients, and studies of acute otitis media in pediatric patients.
Community-Acquired Pneumonia dosage regimen: Safety and effectiveness in the treatment of pediatric patients with community-acquired pneumonia under 6 months of age have not been established. Safety and effectiveness for pneumonia due to Chlamydia pneumoniae and Mycoplasma pneumoniae were documented in pediatric clinical trials. Safety and Zithromax 1000 mg prix Suisse for pneumonia due to Haemophilus influenzae and Streptococcus pneumoniae were not documented bacteriologically in the pediatric clinical trial due to difficulty in obtaining specimens.
Use of azithromycin for these two microorganisms is supported, however, Zithromax 1000 mg Prix Suisse, by evidence from adequate and well-controlled studies in adults. Studies evaluating the use of repeated courses of therapy have not been conducted. Pharmacokinetic parameters in older volunteers years old were similar to those in younger volunteers years old for the 5-day therapeutic regimen.
Dosage adjustment does not appear to be necessary for older patients with normal renal and hepatic function receiving treatment with this dosage regimen. No overall differences in safety or effectiveness were observed between these subjects and younger subjects, and other reported clinical experience has not identified differences in response between the elderly and younger patients, but greater sensitivity of some older individuals cannot be ruled out, Zithromax 1000 mg Prix Suisse.
Adverse Reactions In clinical Zithromax 1000 mg prixes Suisse, most of the reported side effects were mild to moderate in severity and were reversible upon discontinuation of the drug. Potentially serious side effects of angioedema and cholestatic jaundice were reported rarely, Zithromax 1000 mg Prix Suisse. Most of the side effects leading to discontinuation were related to the gastrointestinal tract, e.
Dyspepsia, flatulence, vomiting, melena and cholestatic jaundice. Monilia, vaginitis and nephritis. Dizziness, headache, vertigo and somnolence. Rash, pruritus, photosensitivity and angioedema. Single 1-gram dose regimen: Overall, the most common side effects in patients receiving a single-dose regimen of 1 gram of ZITHROMAX were related to the gastrointestinal system and were more frequently reported than in patients receiving the multiple-dose regimen.
Single 2-gram dose regimen: The majority of these complaints were mild in nature. Single and Multiple-dose regimens: The types of side effects in pediatric patients were comparable to those seen in adults, with different incidence rates for the dosage regimens recommended in pediatric patients.
The incidence, based on dosing regimen, is described in the table below: