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Azithromycin is a macrolide antibiotic, a type of antibiotic that works by stopping the growth of bacteria.[1] It is sold under the brand name Zithromax.

Why It's Prescribed

Azithromycin treats bacterial infections, including bronchitis, pneumonia, ear infections, and some sexually transmitted diseases.[2]

Labeled uses include the following diagnoses:[3] Acute Exacerbation of Obstructive Chronic Bronchitis by M. Catarrhalis, Acute Exacerbation of Obstructive Chronic Bronchitis by Streptococcus Pneumoniae, Acute Exacerbation of Obstructive Chronic Bronchitis due to H. Flu, Acute Gonococcal Cervicitis, Acute Gonococcal Urethritis, Acute Haemophilus Influenzae Bacterial Sinusitis, Acute Moraxella Catarrhalis Bacterial Sinusitis, Acute Otitis Media Infection, Acute Streptococcus Pneumoniae Bacterial Sinusitis, Bacterial Pneumonia, Chancroid, Chlamydia Cervicitis, Chlamydial Pneumonia, Chlamydia Trachomatis Urethritis, Chronic Bronchitis with Bacterial Exacerbation, Disseminated Mycobacterium Avium Complex Infection, Enteric Campylobacteriosis, Haemophilus Influenzae Acute Otitis Media, Haemophilus Influenzae Pneumonia, Moraxella Catarrhalis Acute Otitis Media, Mycoplasmal Pneumonia, Nongonococcal Urethritis, Pharyngitis due to Streptococcus Pyogenes, Pneumococcal Acute Otitis Media, Pneumococcal Pneumonia, Prevention of Mycobacterium Avium Complex Disease, Skin and Skin Structure Streptoccous Pyogenes Infection, Skin and Skin Structure Streptococcus Agalactiae Infection, Staphylococcus Aureus Skin and Skin Structure Infection, Streptococcal Tonsillitis, Streptococcus Acute Otitis Media

Additionally, unlabeled uses include the following:[4] Acquired Immunodeficiency Syndrome with Toxoplasmosis, Boutonneuse Fever, Chlamydia Coinfection with Pharyngeal Gonorrhea, Chlamydia Coinfection with Rectal Gonorrhea, Chlamydia Trachomatis Pelvic Inflammatory Disease, Cholera, Haemophilus Influenzae Bronchitis, Inflammatory Disease of Female Pelvic Organs, Legionella Pneumophila Pneumonia, Moraxella Catarrhalis Bronchitis, Moraxella Catarrhalis Pneumonia, Mycoplasma Hominis Pelvic Inflammatory Disease, Pelvic Inflammatory Disease with Neisseria Gonorrhea, Pertussis, Pneumonia due to Staphylococcus Aureus, Prevention of Bacterial Endocarditis, Sexual Transmitted Disease Exposure from Sexual Assault, Streptococcus Pneumoniae Bronchitis, Traveler's Diarrhea

Form, Route, and Dosage

Azithromycin is available as a tablet or suspension (liquid) to take orally. It is available as a suspension at the strengths 100mg/5ml and 200mg/5ml and as a tablet at the strengths 250mg, 500mg, and 600mg.[5] Typically, adults are prescribed 250mg or 500mg per day. However, sometimes patients with Acute Gonococcal Cervicitis will be prescribed 2000mg to take all at once, one time.[6]


Side Effects

Sometimes patients taking Azithromycin suffer side effects. These may include:[7]

  • upset stomach
  • diarrhea
  • vomiting
  • stomach pain
  • mild skin rash
  • severe skin rash
  • hives
  • itching
  • difficulty breathing or swallowing
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • hoarseness
  • yellowing of the skin or eyes
  • rapid, pounding, or irregular heartbeat

As a Pollutant

Because humans and animals often do not fully metabolize pharmaceuticals in their body, they can excrete drugs or their breakdown products, which may the enter the environment.[8]

In Sewage Sludge

Azithromycin has been found in sewage sludge. In the Targeted National Sewage Sludge Survey, a 2009 test of 84 samples of sewage sludge from around the U.S., the EPA found azithromycin in 80 samples (95%) in concentrations ranging from 10.2 to 6,530 parts per billion.[9] There are no federal regulations governing how much of this drug may be present in sewage sludge applied to land as fertilizer.

In Drinking Water

An Associated Press investigation found that, of 62 metropolitan areas in the U.S., only 28 tested for pharmaceuticals, and 24 found pharmaceuticals in the drinking water when they tested it.[10] The following cities tested positive for azithromycin:[11] Columbus, OH and Philadelphia.

Articles and resources

Related SourceWatch articles


  1. Azithromycin: MedLine Plus Drug Information, Accessed September 2, 2010.
  2. Azithromycin: MedLine Plus Drug Information, Accessed September 2, 2010.
  3. Azithromycin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  4. Azithromycin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  5., Accessed September 2, 2010.
  6. Azithromycin Oral: Dosage, Uses, and Warnings, Accessed September 2, 2010.
  7. Azithromycin: MedLine Plus Drug Information, Accessed September 2, 2010.
  8. O.A.H. Jones, N. Voulvoulis, and J.N. Lester, Human Pharmaceuticals in Wastewater Treatment Processes, Environmental Science and Technology, 2005.
  9. Targeted National Sewage Sludge Survey Report, US EPA website, Accessed August 28, 2010.
  10. AN AP INVESTIGATION : Pharmaceuticals Found in Drinking Water, Associated Press, Accessed September 3, 2010.
  11. Pharmawater-Metros-By-Results, Associated Press, Accessed September 3, 2010.

External resources

External articles