azithromycin

(redirected from Z-max)
Also found in: Dictionary, Thesaurus.

azithromycin

 [az-ith″ro-mi´sin]
a macrolide antibiotic derived from erythromycin, effective against a wide range of gram-positive, gram-negative, and anaerobic bacteria; administered orally or intravenously.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

azithromycin, azithromycin dihydrate

Azasite, Zithromax, Zmax

Pharmacologic class: Macrolide

Therapeutic class: Anti-infective

Pregnancy risk category B

Action

Bactericidal and bacteriostatic; inhibits protein synthesis after binding with 50S ribosomal subunit of susceptible organisms. Demonstrates cross-resistance to erythromycin-resistant gram-positive strains and resistance to most strains of Enterococcus faecalis and methicillin-resistant Staphylococcus aureus.

Availability

Oral suspension: 100 mg/5 ml in 15-ml bottles; 200 mg/5 ml in 15-ml, 22.5-ml, and 30-ml bottles

Oral suspension (Zmax extended-release): 2-g bottle

Powder for injection: 500 mg in 10-ml vials

Powder for oral suspension: 100 mg/5 ml, 200 mg/5 ml, 1,000 mg/packet

Solution (ophthalmic): 1% in 5-ml bottle filled with 2.5 ml solution

Tablets: 250 mg, 500 mg, 600 mg

Tablets (Tri-Pak): three 500-mg tablets

Tablets (Z-Pak): six 250-mg tablets

Indications and dosages

Bacterial conjunctivitis caused by CDC coryneform group G, H. influenzae, S. aureus, Streptococcus mitis group, and S. pneumoniae

Adults: Instill 1 drop in affected eye(s) b.i.d., 8 to 12 hours apart for first 2 days; then instill 1 drop in affected eye(s) once daily for next 5 days

Mild community-acquired pneumonia

Adults: 500 mg P.O. on first day, then 250 mg/day for next 4 days. Or, 2 g P.O. as single dose (extended-release oral suspension).

Children ages 6 months and older: 10 mg/kg P.O. (no more than 500 mg/dose) on day 1, then 5 mg/kg (no more than 250 mg/dose) for 4 more days

Community-acquired pneumonia caused by Chlamydia pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Streptococcus pneumoniae, Legionella pneumophila, Moraxella catarrhalis, and S. aureus

Adults and adolescents ages 16 and older: 500 mg I.V. daily for at least two doses, then 500 mg P.O. daily for a total of 7 to 10 days

Children ages 6 months to 16 years: 10 mg/kg P.O. as a single dose on day 1, then 5 mg/kg P.O. on days 2 through 5

Pharyngitis and tonsillitis

Adults: 500 mg P.O. on day 1, then 250 mg/day for next 4 days, to a total dosage of 1.5 g

Children ages 2 and older: 12 mg/kg P.O. daily for 5 days. Maximum dosage is 500 mg.

Skin and skin-structure infections

Adults: 500 mg P.O. on first day, then 250 mg/day for next 4 days, to total dosage of 1.5 g

Acute bacterial sinusitis

Adults: 500 mg P.O. daily for 3 days; or, 2 g P.O. as single dose (extended-release oral suspension)

Children ages 6 months and older: 10 mg/kg (maximum, 500 mg) P.O. daily for 3 days

Mild to moderate acute exacerbation of chronic obstructive pulmonary disease

Adults: 500 mg/day for 3 days or 500 mg P.O. on day 1, then 250 mg P.O. daily on days 2 through 5; or, 2 g P.O. (extended-release oral suspension) as single dose

Pelvic inflammatory disease caused by Chlamydia trachomatis, Neisseria gonorrhoeae, or Mycoplasma hominis

Adults: 500 mg I.V. daily on days 1 and 2, then 250 mg P.O. daily for a total of 7 days. If anaerobes are suspected, give continually with appropriate anti-anaerobic antibiotic, as ordered.

Nongonococcal urethritis or cervicitis caused by C. trachomatis; genital ulcers caused by Haemophilus ducreyi (chancroid)

Adults: 1 g P.O. as a single dose

Urethritis and cervicitis caused by N. gonorrhoeae

Adults: 2 g P.O. as a single dose

To prevent disseminated Mycobacterium avium complex disease in patients with advanced human immunodeficiency virus

Adults: 1.2 g P.O. once weekly (given alone or with rifabutin)

Acute otitis media

Children ages 6 months and older: 30 mg/kg as a single dose or 10 mg/kg once daily for 3 days; or 10 mg/kg as a single dose on day 1, followed by 5 mg/kg on days 2 through 5

Off-label uses

• Uncomplicated gonococcal infections of cervix, urethra, rectum, and pharynx

Contraindications

• Hypersensitivity to drug, erythromycin, or other macrolide antiinfectives

• None (ophthalmic solution)

Precautions

Use cautiously in:

• severe hepatic impairment, severe renal insufficiency, prolonged QT interval

• breastfeeding patients.

Administration

• Obtain specimens for culture and sensitivity testing before starting therapy.

• Administer tablets and single-dose packets with or without food.

• Give oral suspension 1 hour before meals or 2 hours afterward. With 1-g packet, or single 2-g bottles, mix entire contents in 2 oz of water.

Don't administer as I.V. bolus or I.M. injection.

• For I.V. use, reconstitute 500-mg vial with 4.8 ml of sterile water for injection.

• As appropriate, dilute solution further using normal or half-normal saline solution, dextrose 5% in water, or lactated Ringer's solution.

• Infuse injection over no less than 60 minutes. Infuse 1 mg/ml over 3 hours or 2 mg/2 ml over 1 hour.

• Know that 1,000-mg packet and extended-release oral suspension aren't for pediatric use.

Adverse reactions

CNS: dizziness, drowsiness, fatigue, headache, vertigo

CV: chest pain, palpitations

EENT: eye irritation (with ophthalmic use)

GI: nausea, diarrhea, abdominal pain, cholestatic jaundice, dyspepsia, flatulence, melena, pseudomembranous colitis

GU: nephritis, vaginitis, candidiasis

Metabolic: hyperglycemia, hyperkalemia

Skin: photosensitivity, rashes, angioedema

Other: overgrowth of nonsusceptible organisms (with prolonged use)

Interactions

Drug-drug. Antacids containing aluminum or magnesium: decreased peak azithromycin blood level

Arrhythmias (such as amiodarone, quinidine): increased risk of life-threatening arrhythmias

Carbamazepine, cyclosporine, digoxin, dihydroergotamine, ergotamine, hexobarbital, phenytoin, theophylline, triazolam: increased blood levels of these drugs

HMG-CoA reductase inhibitors (such as atorvastatin, lovastatin): increased risk of myopathy or rhabdomyolysis

Pimozide: prolonged QT interval, ventricular tachycardia

Warfarin: increased International Normalized Ratio

Drug-food. Any food: decreased absorption of multidose oral suspension

Drug-behaviors. Sun exposure: photosensitivity

Patient monitoring

• Monitor temperature, white blood cell count, and culture and sensitivity results.

• Assess for signs and symptoms of infection.

• Monitor patients at risk for cardiac arrhythmia.

Patient teaching

• Tell patient he may take tablets with or without food.

• Advise patient to take suspension 1 hour before or 2 hours after meals.

• Remind patient to complete entire course of therapy as ordered, even after symptoms improve.

• Advise patient not to wear contact lenses if signs or symptoms of bacterial conjunctivitis exist.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, foods, and behaviors mentioned above.

McGraw-Hill Nurse's Drug Handbook, 7th Ed. Copyright © 2013 by The McGraw-Hill Companies, Inc. All rights reserved

azithromycin

(ə-zĭth′rə-mī′sĭn)
n.
A macrolide antibiotic, C38H72N2O12, used to treat a variety of bacterial infections.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

azithromycin

A broad-spectrum, once-daily, advanced-generation macrolide antibiotic used to manage community-acquired and other pneumonias caused by Stretococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, C pneumoniae, M pneumoniae, chlamydial infections, UTIs, Mycobacterium avium complex and possibly also toxoplasmosis and cryptosporidiosis.
 
Adverse effects
Diarrhoea, nausea, vomiting, abdominal pain, vertigo, photosensitivity, hearing loss, injection-site pain.
 
Relative contraindications
Cystic fibrosis, nosocomial infections, bacteremia, advanced age, general debilitation.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.

azithromycin

Zithromax® Infectious disease A broad-spectrum once-daily advanced-generation macrolide antibiotic used to manage community-acquired and other pneumonias caused by S pneumoniae, H influenzae, Moraxella catarrhalis, C pneumoniae, M pneumoniae, chlamydial infections, UTIs, MAC, possibly also toxoplasmosis and cryptosporidiosis Adverse effects Diarrhea, N&V, abdominal pain, vertigo, photosensitivity, hearing loss, injection site pain Relative contraindications Cystic fibrosis, nosocomial infections, bacteremia, elderly, debilitated Pts. See Community-acquired pneumonia.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.

azithromycin

An ANTIBIOTIC drug used in the treatment of a range of infections including genital Chlamydia. A brand name is Zithromax.
Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005

a·zith·ro·my·cin

(ă-zithrō-mīsin)
An antibiotic in the macrolide group.
[azithromycin [coined from parts of the chemical name]]
Medical Dictionary for the Dental Professions © Farlex 2012
References in periodicals archive ?
Caption: At 50 yards, Hornady's Zombie Z-Max (V-Max) shot very well with this 1.13-inch group and without the flier it measured .85 of an inch.
The Z-MAX cord's PCB-based design also enables its unique, high-performance Zero-Cross termination method.
Tellurex says that their test results show the Z-Max's patented semiconductor material gives it a 4[degrees]C cooling advantage over conventional thermoelectric materials.
F A copper system, Z-MAX Category 6A shielded and UTP systems, data
It increases the termination speed for category 5e and 6 UTP Max outlets to the record levels set by Siemon's Z-Max category 6A UTP and shielded outlets, allowing contractors to maximise their labour efficiency and profitability across the full range of Siemon's category 5e and 6A cabling systems, he added.
.40 S&W FACTORY AMMO PERFORMANCE LOAD (BRAND, BULLET VELOCITY ENERGY GROUP SIZE WEIGHT, TYPE) (FPS) (FT-LBS) (INCHES) Remington 165 FMJ 982 353 2.3 Black Hills 140 TAC XP 1,181 434 2.2 Black Hills 155 JHP 1,179 479 3.2 Hornady 155 XTP 1,205 499 3.5 Hornady 165 FTX 1,201 529 3.3 Hornady 165 Z-Max 1,057 409 2.7 CorBon 140 DPX 1,121 390 1.7 CorBon 165 JHP 1,107 449 2.6 Notes: Groups fired from casual padded rest at Eb yards.
2 Hornady's new line of Zombie Ammunition features Z-Max bullets and can be had in 9mm..40 S&W,.45 ACP,.223, 7.62x39 and.308.
Starting with the original Solocam, and with bows like the Z-Max, MQ-1 and MQ-32, there's a lot of speed, accuracy and solid construction.
The bows I'm considering are Mathews' Z-Max, Feather Max, or Ultra Max; PSE's ThunderBolt Lightning Cam; and Parker's Super Magnum.