From the Guidelines
For the treatment of pneumonia, the recommended dose of azithromycin is 10 mg/kg on day 1, followed by 5 mg/kg/day once daily on days 2-5, with a maximum dose of 500 mg on day 1 and 250 mg on subsequent days 1. This dosage is based on the guidelines for the management of community-acquired pneumonia in infants and children older than 3 months of age, as recommended by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. The guidelines suggest that azithromycin is effective against many common pneumonia-causing bacteria, including Mycoplasma pneumoniae and Chlamydophila pneumoniae, due to its broad spectrum of activity and good lung penetration. Some key points to consider when prescribing azithromycin for pneumonia include:
- Always complete the full course of antibiotics, even if symptoms improve
- Take with or without food, but taking with food may help if stomach upset occurs
- The extended dosing regimen allows for once-daily dosing and a shorter overall treatment duration compared to some other antibiotics
- For children, the dose is weight-based, with a maximum dose of 500 mg on day 1 and 250 mg on subsequent days
- Azithromycin is a suitable option for outpatient treatment of pneumonia in children, particularly for those with presumed atypical pneumonia 1.
From the FDA Drug Label
Adults Infection *Recommended Dose/Duration of Therapy *DUE TO THE INDICATED ORGANISMS (See INDICATIONS AND USAGE.) Community-acquired pneumonia (mild severity) 500 mg as a single dose on Day 1, followed by 250 mg once daily on Days 2 through 5
The recommended dose of azithromycin for community-acquired pneumonia (mild severity) in adults is 500 mg as a single dose on Day 1, followed by 250 mg once daily on Days 2 through 5 2.
- Key points:
- Dose: 500 mg on Day 1, then 250 mg daily on Days 2-5
- Indication: Community-acquired pneumonia (mild severity)
- Population: Adults
From the Research
Recommended Dose of Azithromycin for Pneumonia
The recommended dose of azithromycin for pneumonia varies depending on the specific type of pneumonia and the patient population.
- For atypical pneumonia, a single 1.5 g dose of azithromycin may be an alternative to the standard 3-day azithromycin regimen 3.
- A 1.5 g total dose of azithromycin is equally effective when administered as a three- or five-day regimen for the treatment of atypical pneumonia 4.
- For community-acquired pneumococcal pneumonia, a three-day course of azithromycin with a total dose of 1.5 g seems effective and safe in patients with no underlying pulmonary condition 5.
- A single 2.0-g oral dose of a novel microsphere formulation of azithromycin was at least as effective as 7 days of levofloxacin in the treatment of adult patients with mild to moderate community-acquired pneumonia 6.
Comparison with Other Antibiotics
- Azithromycin appears to be as effective as erythromycin in the treatment of atypical pneumonias and better tolerated 7.
- The efficacy and safety of azithromycin compared to other antibiotics, such as levofloxacin, have been demonstrated in clinical trials 6.