Why is Azithromycin Not Working?

Why is Azithromycin not working

Antibiotic resistance can be considered as the first and foremost cause of Azithromycin to not work properly. Azithromycin is a broad spectrum macrolide antibiotic used to treat various bacterial infections. This antibiotic was approved in 1988 for public use. Nowadays, azithromycin has lost its potential to work against certain bacteria due to its unjustified use.

Antibacterial resistance is the main reason for Azithromycin to lose its effectiveness, again, some drugs can reduce the effectiveness of Azithromycin. That can also cause Azithromycin to not work properly.

Mechanism of action of Azithromycin

Azithromycin has immunomodulatory, anti-inflammatory, and anti-bacterial effects. It works by inhibiting bacterial growth by binding with the 50S ribosomal subunit of bacteria and interfere with bacterial protein synthesis. Thus, the growth and reproduction of bacteria is hampered. Azithromycin is a bacteriostatic antibiotic but it can be bactericidal at high doses.

The Reason Behind Azithromycin Losing Effectiveness

During the COVID-19 pandemic, people irrationally used Azithromycin, although it was a SARS-COV-2 viral infection. Still, some corrupt and irresponsible retailers sell antibiotics without any prescription which is against drug law in many countries.

  • Azithromycin resistance
  • Resistance of Azithromycin in a newborn or who didn’t use this medicine before through genetically
  • Usage of Azithromycin in viral infection
  • Usage of other macrolides along with Azithromycin
  • Taking Azithromycin and Antacid drugs together
  • Not completing the dose of Azithromycin

Indications of Azithromycin

WHO listed Azithromycin as an essential medicine, it is indicated for several bacterial infections such as:

  • Pneumonia caused by Hlamydophila pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, or Streptococcus pneumoniae
  • Pharyngitis or tonsillitis caused by Streptococcus pyogenes
  • Skin infections caused by Staphylococcus aureus, Streptococcus pyogenes, or Streptococcus agalactiae
  • Chronic Obstructive Pulmonary disease (COPD) or bronchitis caused by Haemophilus influenzae, Moraxella catarrhalis, or Streptococcus pneumonia
  • Sexually Transmitted Diseases (STD)
  • Traveler’s diarrhea by Helicobacter pylori
  • Whooping cough etc.

Side effects of Azithromycin

Although Azithromycin is a safe drug, still it might have some side effects:

  • Nausea
  • Vomiting
  • Diarrhea
  • Loss of appetite
  • Tiredness
  • Loss of taste

These are some normal side effects associated with Azithromycin but don’t delay to consult your physician if you feel serious effects like Arrhythmia (irregular heartbeat), Tinnitus (hearing difficulties), Vertigo (dizziness or loss of balance), Pancreatitis (inflammation in back) or severe diarrhea.

Contraindication of Azithromycin

Contraindication is a medical term that indicates to loss of effectiveness of any drug or reaction to a drug with other drugs or substances.

  • Patient with a history of hypersensitivity with Azithromycin
  • Patient with a history of Arrhythmia
  • Parallel use of any other macrolide antibiotic
  • Patients with severe liver or kidney diseases
  • Aluminum and Magnesium containing antacid drugs slow down the effectiveness of Azithromycin

Final thought

Azithromycin was first developed in 1980 by a Pharmaceutical company named “Pilva” and it was a life-saving discovery against bacterial infections. However insensitive use of Azithromycin caused the resistance of this antibiotic drug. Sometimes patients use Azithromycin due to illiteracy or some quack or fake physicians also prescribe azithromycin without caring about antibiotic resistance. People’s awareness is necessary for the proper use of antibiotics and completing the dose regime.

Today, a newborn child is now resistant to Azithromycin which is an alarming condition. To save crores of lives, strict drug rules and implementation are necessary and our doctors should be more careful during prescribing antibiotics with proper testing whether the disease is caused by bacteria or viruses.

Pharmacologist I Researcher Research Coordinator Working site: Rajshahi Medical College Hospital, Rajshahi, Bangladesh Toxicology Society of Bangladesh