Azithromycin is considered appropriate in the following situations:

1. Mycobacterium avium-intracellulare complex infections in immunocompromisedpatients.

2. Alternative oral therapy in erythromycin-intolerant (documented) patients.

1. Upper respiratory tract infections

2. Lower respiratory tract infections

3. Skin and soft tissue infections

3. Orally in noncompliant (documented) patient with Chlamycia trachomatis infection

4. Intravenous as a single agent for community acquired pneumonia

5. In BMT patients for toxoplasmosis prophylaxis

6. In BMT patients for suspected legionella infections

Dose:

1. Azithromycin is given once daily.

2. Mycobacterium avium-intracellulare complex - 500 mg daily

3. Usual oral therapy - 500 mg for first dose/day; 250mg for next four doses/days for a total of 5 doses/days.

4. Chlamydia trachomatis - single dose of 1000 mg

5. Intravenous - 500 mg daily for 2-3 days and change to 250mg oral for 5 - 7 days.

May use 500 mg daily for 10 days where oral therapy is not feasible

Note: 500mg IV is equivalent to 1300 mg oral.

Monitor:

1. Administer oral drug 1 hour before or 2 hours after a meal.

2. Do not give drug simultaneously with aluminum and magnesium-containing antacids

3. Do not give concurrently with astemizole. May cause cardiotoxicity.

4. If intravenous azithromycin is used, switch to oral drug as soon as feasible. Monitor routinely for IV to PO switch.