From the Guidelines
Azithromycin should be prescribed at a dose of 10 mg/kg on day 1, followed by 5 mg/kg/day once daily on days 2–5 for the treatment of pneumonia in children, with a maximum dose of 500 mg on day 1 and 250 mg on days 2–5 for children over 5 years old. This dosage recommendation is based on the guidelines for the management of community-acquired pneumonia in infants and children older than 3 months of age, as outlined in the study by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America 1. The study provides a comprehensive overview of empiric therapy for pediatric community-acquired pneumonia, including dosage recommendations for azithromycin. Some key points to consider when prescribing azithromycin for pneumonia include:
- The medication should be taken orally, with or without food, although food may help reduce stomach upset
- Patients should complete the full 5-day course of treatment, even if they start feeling better before finishing the medication
- Azithromycin works by inhibiting bacterial protein synthesis, making it effective against common pneumonia-causing pathogens
- Patients with certain medical conditions, such as liver or kidney disease, or those taking certain medications, should inform their doctor as dosage adjustments may be necessary
- Common side effects of azithromycin include nausea, diarrhea, and abdominal pain, as noted in the study 1.
From the FDA Drug Label
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 oral suspension for the treatment of pediatric patients with community-acquired pneumonia is 10 mg/kg as a single dose on the first day followed by 5 mg/kg on Days 2 through 5.
The recommended dosage for azithromycin in the treatment of community-acquired pneumonia is:
- For adults: 500 mg as a single dose on Day 1, followed by 250 mg once daily on Days 2 through 5.
- For pediatric patients: 10 mg/kg as a single dose on the first day followed by 5 mg/kg on Days 2 through 5 2.
From the Research
Azithromycin Dosage for Pneumonia
- The dosage of azithromycin for pneumonia varies depending on the severity and type of pneumonia, as well as the patient's age and weight.
- According to a study published in 1991 3, a total dose of 1.5 g azithromycin was effective in treating atypical pneumonia, with patients receiving either 500 mg once daily for three days or 250 mg twice daily on day 1 followed by 250 mg once daily for four days.
- Another study published in 2002 4 used azithromycin 500 mg IV once daily for at least two days, followed by an optional transition to oral azithromycin 500 mg once daily, in combination with ceftriaxone 1 g IV once daily for two days.
- A 2009 study 5 compared the medical resource utilization of patients with community-acquired pneumonia who received initial treatment with levofloxacin 750 mg daily versus ceftriaxone 1000 mg plus azithromycin 500 mg daily, but did not specify the duration of azithromycin treatment.
- A 2018 study 6 compared the efficacy of oral levofloxacin 750 mg once daily for five days versus parenteral ceftriaxone 1 g twice daily plus oral azithromycin 250 mg once daily for seven to ten days in hospitalized patients with community-acquired pneumonia.
Treatment Duration and Efficacy
- The treatment duration of azithromycin for pneumonia can range from three to ten days, depending on the severity and type of pneumonia.
- Studies have shown that azithromycin is effective in treating pneumonia, with clinical success rates ranging from 92.3% to 94.1% 4, 3.
- The efficacy of azithromycin in combination with other antibiotics, such as ceftriaxone, has also been demonstrated in several studies 4, 5, 6.