From the Guidelines
For acute bacterial bronchitis, the recommended dose of Zithromax (azithromycin) is 500 mg on the first day, then 250 mg daily 1. This dose is based on the guidelines for the diagnosis and treatment of adults with community-acquired pneumonia, which includes acute bacterial bronchitis, from the American Thoracic Society and Infectious Diseases Society of America 1. The total duration of the treatment is typically 5 days, providing a total dose of 1.5 grams. Key points to consider when prescribing azithromycin for acute bacterial bronchitis include:
- The medication can be taken with or without food, though taking it with food may reduce stomach upset.
- Patients should complete the entire course even if symptoms improve before finishing the medication.
- Azithromycin works by inhibiting bacterial protein synthesis, preventing bacteria from growing and multiplying.
- Common side effects may include nausea, diarrhea, and abdominal pain.
- Patients should be aware that azithromycin can interact with certain medications, particularly those affecting heart rhythm, so it's essential to inform healthcare providers about all medications being taken 1.
From the FDA Drug Label
Adults
- Acute bacterial exacerbations of chronic obstructive pulmonary disease (mild to moderate) 500 mg QD × 3 days OR 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 acute bacterial bronchitis is not explicitly stated, but for acute bacterial exacerbations of chronic obstructive pulmonary disease (mild to moderate), the dose is 500 mg QD × 3 days or 500 mg as a single dose on Day 1, followed by 250 mg once daily on Days 2 through 5. Since acute bacterial bronchitis is not directly mentioned, but is related to chronic obstructive pulmonary disease, a conservative clinical decision would be to use the dose for acute bacterial exacerbations of chronic obstructive pulmonary disease. However, it is essential to note that this is an indirect inference, and the label does not directly address acute bacterial bronchitis. 2
From the Research
Recommended Dose of Zithromax (Azithromycin) for Acute Bacterial Bronchitis
The recommended dose of Zithromax (azithromycin) for acute bacterial bronchitis is as follows:
- 500 mg once daily for 3 days 3, 4, 5, 6
- Alternatively, 500 mg on day 1, followed by 250 mg/day on days 2-5 7
Efficacy of Azithromycin in Treating Acute Bacterial Bronchitis
Azithromycin has been shown to be effective in treating acute bacterial bronchitis, with clinical cure rates ranging from 80% to 96% 3, 7, 4, 5, 6
- Azithromycin has been compared to other antibiotics, such as amoxicillin, clarithromycin, and co-amoxiclav, and has been found to be equally effective 3, 7, 4, 5
- Azithromycin has also been shown to be effective in eradicating common pathogens, such as Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis 3, 4, 5
Safety and Tolerability of Azithromycin
Azithromycin has been found to be well-tolerated, with few adverse events reported 3, 7, 4, 5, 6