Azithromycin and lungs

Q: Azithromycin is an effective antibiotic for pulmonary infections because levels in the lung can be 10 to 100 times more than in plasma.

A) True

B) False

Answer: A

Azithromycin penetrates very well into most tissues and fluids, giving it great credibility as an anti-infective, particularly for the lung. This also includes its high concentration in epithelial lining fluid, neutrophils, and alveolar macrophages. In this regard, azithromycin performs better than clarithromycin. 

Sputum and lung concentrations are 10 to 100 times higher in the plasma.

Moreover, this high level of azithromycin persists in tissues for extended periods, though it can be seen as a risk for resistance development.

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References:

1. Nesbitt WJ, Aronoff DM. Macrolides and clindamycin. In: Principles and Practice of Infectious Diseases, 9th ed, Bennett JE, Dolin R, and Blaser MJ (Eds), Elsevier, 2020.

2. Ballow CH, Amsden GW. Azithromycin: the first azalide antibiotic. Ann Pharmacother 1992; 26:1253.