Azithromycin use in paediatrics: a practical overview Flashcards

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1
Q

What are the pharmacokinetic properties of azithromycin?

A
  1. Stable in acidic pH
  2. Bioavailability >30%
  3. Relatively long half life up to 96h
  4. Significant intracellular diffusion
  5. Transported in cells not blood
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2
Q

What is the mechanism of action for azithromycin?

A

Inhibits bacterial protein synthesis by binding to the 50S subunit of ribosomes and blocking protein translocation

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3
Q

What is the spectrum of activity for azithromycin?

A

Lower in vitro activity against gram positive bacteria i.e. streptococcus pneumoniae but better in vitro activity against gram negative bacteria i.e. H. flu and Moraxella catarrhalis

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4
Q

When should azithromycin be used to treat acute pharyngitis, AOM, or CAP in otherwise healthy children?

A
  1. Second line treatment in cases of life-threatening beta-lactam allergy to treat acute pharyngitis caused by macrolide sensitive GAS
  2. Pneumonia caused by atypical bacteria
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5
Q

What is the concern with increased prescription of azithromycin?

A

Rising rates of resistance especially pneumococci

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6
Q

Why is azithromycin prescribed commonly?

A
  1. Once daily dosing
  2. Short treatment duration (3-5 days)
  3. Favourable side effect profile
  4. Easy administration in oral prescription
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