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Precautions for Administration of Azithromycin Tablets (Azithromycin)
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Article source: Seagull Pharmacy
Nov 05, 2025

Azithromycin Tablets (Azithromycin) belong to the class of macrolide antibiotics and are widely used in the treatment of respiratory tract infections, skin and soft tissue infections, as well as sexually transmitted diseases.

Precautions for Administration of Azithromycin Tablets (Azithromycin)

Screening for Allergy History

Confirm whether the patient has a history of hypersensitivity to azithromycin, erythromycin, any macrolide, or ketolide drugs.

If such an allergy history exists, the use of this product shall be prohibited, as it may trigger severe allergic reactions including angioedema and anaphylactic shock.

Assessment of Liver Function Status

Patients who have experienced cholestatic jaundice/hepatic insufficiency after previous use of azithromycin shall be strictly prohibited from using this product.

Before medication, special attention should be paid to the presence of risk factors for active liver disease.

Monitoring for Cardiotoxic Reactions

Azithromycin may cause prolongation of the QT interval, leading to life-threatening arrhythmias such as torsades de pointes.

Focus should be placed on the following high-risk groups: patients with a known history of QT interval prolongation, those taking class IA or class III antiarrhythmic drugs, and patients with uncorrected hypokalemia or hypomagnesemia.

Elderly patients are more sensitive to the drug-related QT interval effects, so enhanced electrocardiographic monitoring is required during the medication period.

Management of Hepatotoxic Reactions

During the medication period, abnormal liver function, hepatitis, and cholestatic jaundice may occur; in severe cases, it can progress to hepatic necrosis and liver failure.

If patients present with unexplained symptoms such as nausea, vomiting, loss of appetite, abdominal pain, fatigue, darkening of urine, or scleral icterus, they must stop taking the drug immediately and seek medical attention.

Patients with a history of hepatic insufficiency should undergo regular monitoring of liver enzyme levels during the medication period.

Warning for Exacerbation of Myasthenia Gravis

Azithromycin may exacerbate symptoms in patients with myasthenia gravis.

During the medication period, close observation of changes in muscle strength is necessary; if exacerbation of myasthenia or newly developed myasthenic syndrome occurs, timely intervention is required.

Medication Monitoring for Azithromycin Tablets (Azithromycin)

Monitoring of Laboratory Indicators

Hematological indicators such as hemoglobin, hematocrit, and neutrophils should be tested regularly.

For liver function monitoring, focus should be on changes in enzymatic indicators including alanine transaminase (ALT), aspartate transaminase (AST), and gamma-glutamyl transferase (GGT).

In pediatric patients, special attention should be paid to the neutrophil count (which may decrease to 500-1500 cells/mm³).

Monitoring of Bacterial Resistance

To reduce the development of drug-resistant bacteria, azithromycin should only be used for the treatment of infections that are confirmed or highly suspected to be caused by susceptible bacteria.

Etiological evidence should be obtained as much as possible before treatment.

Precautions for Special Examinations

For patients receiving warfarin therapy, close monitoring of changes in prothrombin time is required.

Note: For internal discussion among medical personnel only. For specific medication, please consult the attending physician. Drug information may change over time. For the latest information, we recommend adding a medical consultant or consulting for free online.
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