From the Guidelines
Azithromycin Dosing for Community-Acquired Pneumonia (CAP) in Hospitalized Patients
Azithromycin is recommended at a dose of 500mg on the first day, followed by 250mg daily for a total duration of 5-7 days for mild to moderate cases, or 7-10 days for more severe cases in hospitalized patients with Community-Acquired Pneumonia (CAP) 1.
- The choice between intravenous (IV) and oral administration depends on the patient's clinical condition and ability to tolerate oral medication 1.
- Azithromycin remains a viable option due to its long serum and tissue half-life, allowing for shorter treatment courses compared to other antibiotics 1.
- Clinical guidelines suggest that for inpatients, the duration of therapy can range from 7-10 days, with some studies indicating that shorter courses may be effective, especially with newer agents like azithromycin 1.
- It's crucial to assess the patient's response to treatment and adjust the antibiotic regimen as necessary, considering factors such as the severity of the pneumonia, risk for drug resistance, and the patient's clinical progress 1.
- The dosing regimen of 500mg on the first day, followed by 250mg daily, is supported by studies examining the efficacy of azithromycin in treating CAP, including its use against "atypical pathogens" and bacterial pathogens 1.
From the FDA Drug Label
The recommended dose of Azithromycin for Injection for the treatment of adult patients with community-acquired pneumonia due to the indicated organisms is: 500 mg as a single daily dose by the intravenous route for at least two days Intravenous therapy should be followed by azithromycin by the oral route at a single, daily dose of 500 mg, administered as two 250 mg tablets to complete a 7 to 10 day course of therapy.
The dose of azithromycin for Community-Acquired Pneumonia (CAP) in hospitalized patients is:
- 500 mg as a single daily dose by the intravenous route for at least 2 days
- Followed by 500 mg orally per day to complete a 7 to 10 day course of therapy 2
From the Research
Dosing of Azithromycin for Community-Acquired Pneumonia (CAP) in Hospitalized Patients
- The dose of azithromycin for CAP in hospitalized patients is typically 500 mg daily, as seen in studies comparing azithromycin plus ceftriaxone to levofloxacin 3, 4.
- In one study, patients who improved clinically were switched to oral follow-on therapy with azithromycin 500 mg/day 3.
- Another study used a single 2.0-g dose of azithromycin microspheres, which was as effective as a 7-day course of extended-release clarithromycin in the treatment of adults with mild-to-moderate CAP 5.
- A study comparing azithromycin 1 g once daily for 3 days to amoxicillin-clavulanate 875/125 mg twice daily for 7 days found that azithromycin was at least as effective as amoxicillin-clavulanate in the treatment of adult patients with community-acquired pneumonia 6.
- Azithromycin monotherapy has been shown to be equally as efficacious as other recommended regimens for treating hospitalized patients with mild-to-moderate community-acquired pneumonia, with a typical dose of 500 mg daily 7.