Parenteral Manual

Azithromycin dihydrate

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
ZITHROMAX®
Classification: 
Macrolide antibiotic
Original Date: 
August 2005
Revised Date: 
August 2015
Indications: 
  • Infections of the skin and skin structure, urethritis and cervicitis
  • Endocarditis prophylaxis
Reconstitution and Stability: 

VIAL SIZE

STERILE WATER for INJECTION REQUIRED

FINAL CONCENTRATION

500 mg

4.8 mL

100 mg/mL
  • Reconstituted solution stable for 24 hours at room temperature or 3 days refrigerated
  • Diluted solutions (1-2 mg/mL) stable 24 hours at room temperature or 7 days refrigerated
Compatibility: 

- Solutions Compatible:  D5W, NS, 0.45NaCl, ringer's lactate, dextrose-saline combinations

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: diphenhydramine

- Incompatible: amikacin, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, ciprofloxacin, clindamycin, fentanyl, gentamicin, morphine, potassium chloride, tazocin

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct NO
IV Intermittent Infusion

YES
Syringe pump dilution: 2 mg/mL ONLY

 

Large volume pump dilution: 1-2 mg/mL. Don't use a minibag smaller than 50 mL

Infusion time: 1 hour
IV Continuous Infusion NO
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric: Respiratory Infection:   

  • 10 mg/kg/day IV Q24H   Maximum dose:  500 mg          

Adult/adolescent: 

  • 500 mg IV Q24H for 2 days, followed by oral
Potential hazards of parenteral administration: 
  • Hypersensitivity
  • Serious allergic reactions
  • Rash, thrombophlebitis, extravasation, Stevens-Johnson syndrome, toxic epidermal necrolysis
  • Side effects of nausea, vomiting, diarrhea, abdominal pain, hepatotoxicity, elevated liver enzymes (reversible) and ototoxicity

 

Notes: 
  • Caution in hepatic or renal impairment
  • No dosage adjustment required for patients with mild to moderate hepatic impairment or mild renal impairment
  • Contraindicated if allergy to azithromycin, erythromycin or any macrolide
  • Monitor liver function tests, WBC with differential

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