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Because of this, tissue concentrations are significantly higher than are plasma concentrations. Azithromycin is distributed widely into brain tissue however, not into cerebrospinal fluid or the aqueous humor of the eye. Protein binding varies with plasma concentration; 51% of the drug is bound at low concentrations (0.02 mcg/ml) which binding decreases to 7% at higher concentrations (2 mcg/ml). Azithromycin has a long half-life in both adults and children , which is partially explained by its considerable tissue uptake and slow release. Elimination is largely in the feces, following excretion in to the bile, with less than 14% excreted in the urine. 250 to 500 mg PO 3 days per week has been recommended to lessen exacerbation rates.
Prescribing ZITHROMAX in the lack of a successful or strongly suspected bacterial infection is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria. Local IV site reactions have been reported with the intravenous administration of azithromycin. The incidence and severity of these reactions were the same when 500 mg azithromycin was given over one hour (2 mg/mL as 250 mL infusion) or higher 3 hr (1 mg/mL as 500 mL infusion) . All volunteers who received infusate concentrations above 2.0 mg/mL experienced local IV site reactions and, therefore, higher concentrations should be avoided.
In manipulated clinical studies, azithromycin has been administered to pediatric patients age 6 months to 16 years by the oral route. Pharmacokinetics of azithromycin following oral administration in older volunteers years old were a lot like those in younger volunteers years of age for the 5-day therapeutic regimen. No overall variations safely were observed between these subjects and younger subjects in terms of adverse events, laboratory abnormalities, and discontinuations. Virtually all antibacterial agents, including systemic azithromycin, have been associated with pseudomembranous colitis or C.