Q: Why is a short course of azithromycin considered relatively sufficient in comparison to other macrolides?
Answer: For most infections, a once-daily 5-day regimen of azithromycin is considered as effective as 10-day courses of the other macrolides.
This is because azithromycin has a long intracellular half-life (40 to 68 hours) and a slow rate of release from tissue sites. For example, a 2-gram extended-release oral suspension of azithromycin is given as a single dose due to its long half-life. The only caution is to take the extended-release suspension 1 hour before or 2 hours after meals, and to consume it within 12 hours of reconstitution.
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References:
1. Azithromycin extended-release (Zmax) for sinusitis and pneumonia. Med Lett Drugs Ther 2005; 47:78.
2. Crokaert F, Hubloux A, Cauchie P. A Phase I Determination of Azithromycin in Plasma during a 6-Week Period in Normal Volunteers after a Standard Dose of 500mg Once Daily for 3 Days. Clin Drug Investig. 1998;16(2):161-6. doi: 10.2165/00044011-199816020-00009. PMID: 18370534.
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