Zithromax is the brand name for azithromycin. Many are familiar with it as a Z-Pak, a packet of antibiotic tablets, usually taken for five days.
Its status is justified by its brevity, a straightforward regime and the fact that many patients have taken it without issue. It has also gained the reputation as the antibiotic requested when a cough is stubborn or a cold turns unpleasant.
However, that popularity may be deceptive. Azithromycin has its place, when the illness is caused by bacteria the antibiotic can target. There is no benefit over other treatments against cold and flu, however miserable the sufferers may feel.
Green mucus cannot be overlooked either. It often accompanies viral infections as a result of white blood cells being attracted to the infected area collecting in the mucus. While the green hue can be startling, it is not a sign of bacterial infection and therefore of the need for an antibiotic.
What is Zithromax used for?
Azithromycin works by disrupting protein synthesis in bacteria. Doctors prescribe it for selected chest, ear, sinus and skin infections. It can also be prescribed for certain sexually transmitted infections.
“Selected”
is the key word.
Take chest infection as an example. One person may have bacterial pneumonia and require an antibiotic. Another can have almost identical coughing and fever as a result of influenza. A third may have bronchitis that will run its course without treatment. Listening to the patient can help, but an examination, a swab or a chest X-ray can sometimes be needed before the picture is clear.
Doctors also take into account antibiotic resistance. Azithromycin has been used extensively and there are strains of bacteria that are now less responsive to it. Choosing amoxicillin, doxycycline or another treatment does not make Zithromax weaker, but other bacteria are more likely to be present.
Why is a Z-Pak so short?
The familiar Z-Pak consists of a higher dose on the first day followed by a lower daily dose for another four days. Another infection may have a different regime, so an old packet is of limited use as a guide.
Azithromycin has a long shelf life in the tissue. It continues to work after the final tablet has been taken, which is why a short course is sufficient.
Take each dose at around the same time. The tablets can be taken with or without food, although a little food may assist if the medication causes the stomach to feel unwell. Do not take antacids containing aluminium or magnesium at the same time without first checking with a pharmacist.
If a dose is forgotten, take it when remembered, unless it is almost time for the next one. Taking two tablets at once will not make up for a forgotten or late dose, but can be an ordeal to take. An uncomfortable afternoon may be the price to pay.
What does taking Zithromax feel like?
There has been little beyond the initial improvement of the infection.
When side effects do occur, the stomach is the first to complain. Nausea, cramping and loose stools are common enough to not be surprising, but they are usually mild and pass after treatment.
There does come a point when the diarrhea goes beyond an annoyance. Frequent watery stools, blood, fever or strongly painful cramps are reasons to seek medical advice. Antibiotics can cause a disruption to the balance of bacteria in the bowel and can result in an infection called C. difficile being present, either when taking the Z-Pak or some weeks after the course has finished.
A new rash should also be mentioned. Difficulty breathing, blistering skin or swelling around the mouth and throat require urgent care.
Azithromycin can have an effect on the heart’s natural rhythms in a minority of cases. It is a concern if you already have a heart rhythm disorder, an abnormally slow heartbeat, heart failure or low potassium or magnesium levels. Other medications can contribute to the problem, so it is not the time to forget half the medication list.
Liver problems are rare, but there is the potential for them. Dark urine, yellow eyes, persistent vomiting or an exhaustion that seems completely disproportionate should prompt a call to a doctor.
The tablets left in the cupboard
A common pharmacy conversation begins with, “I have three azithromycin tablets left from last time.”
Those tablets should not be the beginning of a new and home-grown course of treatment. Three may be the wrong number. The illness may be viral, even if bacteria are involved, they may not be responsive to azithromycin.
Nor should the tablets be passed to a partner because both people started coughing in the same week. One may have the same infection, or not.
Take Zithromax for the number of days written on the prescription. Feeling better early does not mean it is time to stop, and feeling unwell after the last dose does not mean it is time to extend the course yourself.
More information about Zithromax and other antibiotic treatments can help with the options. However, the most useful question is not “which antibiotic is strongest?” but “do I need an antibiotic, and which one fits this infection?”
Zithromax can be an excellent answer. It just should not be the answer chosen before the question has been asked.
