What is the total quantity of Azithromycin (Zithromax) taken over 5 days with 120mg on day 1 and 60mg daily for days 2-5?

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Total Quantity Calculation for Azithromycin Regimen

The total quantity of azithromycin for this regimen is 360 mg over 5 days (120 mg on day 1 + 60 mg × 4 days = 120 + 240 = 360 mg total).

Breakdown by Day

  • Day 1: 120 mg
  • Days 2-5: 60 mg daily × 4 days = 240 mg
  • Total course: 360 mg 1, 2

Clinical Context and Dosing Considerations

This 360 mg total dose regimen is substantially lower than standard azithromycin dosing for most bacterial infections and does not align with established guideline recommendations for any common indication 1, 2.

Standard Pediatric Dosing for Comparison

For most pediatric bacterial infections, the standard regimen is:

  • 10 mg/kg on day 1 (maximum 500 mg)
  • 5 mg/kg daily on days 2-5 (maximum 250 mg/day)
  • Total dose: approximately 30 mg/kg over 5 days 1, 2, 3

For streptococcal pharyngitis specifically:

  • 12 mg/kg once daily for 5 days (maximum 500 mg/day)
  • Total dose: 60 mg/kg over 5 days 4, 5

Weight Estimation for This Regimen

If this 360 mg total dose represents a standard 30 mg/kg regimen, the patient would weigh approximately 12 kg (360 mg ÷ 30 mg/kg = 12 kg) 1, 3.

Important Clinical Caveats

This dosing regimen appears to be a pediatric prescription based on the total dose of 360 mg, which is well below adult dosing 1, 2.

Standard adult regimens for comparison:

  • Community-acquired infections: 500 mg day 1, then 250 mg days 2-5 (total 1500 mg) 1, 2
  • Single-dose therapy for chlamydia: 1000 mg once (total 1000 mg) 1, 2
  • Chronic therapy for bronchiolitis obliterans: 250 mg daily for 5 days, then 250 mg three times weekly 6

The 360 mg total dose is appropriate only for a small child (approximately 12 kg or 26 pounds), and prescribers should verify weight-based dosing calculations before dispensing 1, 3.

References

Guideline

Azithromycin Dosing for Bacterial Infections

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Azithromycin Dosing Recommendations

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Azitromicina en Amigdalitis Estreptocócica

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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