Azithromycin is a commonly used clinical drug, and in many cases, azithromycin is the clinician's preferred antibiotic, especially for mycoplasma infections. Dr. Zhang's daughter also took azithromycin after mycoplasma infection, so I have also checked a lot of information about azithromycin. At the same time, a friend also asked me this kind of question today, so I also answer this question.

I am often asked by a friend with the Azithromycin drug insert, saying, "The insert states that the safety of this product in children or patients under 16 years of age is not known. What should I understand about this statement? Can azithromycin be used in children or not?" This question is asked very well, indicating that the family is a careful family members, today Dr. Zhang and you talk about azithromycin, children patients in the end can not eat the problem.

First, a general overview of the drug Azithromycin. It is a macrolide antibiotic. It was approved for marketing by the FDA in 1991 and can be used in the following conditions: 1. Streptococcus pyogenes infections.2. Sinusitis, otitis media, soft-tissue skin infections, acute bronchitis, and acute exacerbation of chronic bronchitis caused by susceptible bacteria.3. Pneumonia due to Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae.4. Urethritis and cervicitis caused by Chlamydia trachomatis. Therefore, it is widely used in the clinic.

The instructions for Azithromycin Injection do state that the safety of using this product in children or patients under 16 years of age is unknown. However, azithromycin is in the vast majority of the country in widely due among pediatric patients, especially for the treatment of mycoplasma infections and respiratory bacterial infections. So, is Azithromycin safe for use in children?

A study was conducted by Wu Rongchu et al. The authors followed up a total of 19,831 cases of azithromycin use in patients under 16 years of age (Wu Rongchu, Yu Qilu, Tian Chunhong, Guo Xiaoling, Zou Jiancheng, Deng Huishan, Li Xinqiang, Deng Beilin, Xiao Yipeng. A study on the safety of azithromycin in children[J]. (Pharmacy Today,2011,21(4):240-242.). Study Findings:

The incidence of adverse reactions to azithromycin was low, totaling 276 cases (1.39%). And most of them occurred after 1 hour of administration, with pain, nausea and allergic reactions caused by injection administration appearing the fastest, with the shortest being less than 2 minutes

The most common adverse reactions are gastrointestinal reactions such as nausea, vomiting, and diarrhea. It was also found that oral azithromycin produced the least number of adverse reactions, and that the combination of injections and oral use produced the most adverse reactions.

Therefore, Dr. Zhang believes that azithromycin is safe for the vast majority of pediatric patients, especially oral azithromycin, but attention should be paid to its possible adverse effects.

First of all, first of all, you this specific problem, the hospital infusion azithromycin, I do not know whether there is no relevant laboratory tests, if there is no blood test, on the infusion of azithromycin, then this doctor is a very irresponsible doctor! Infusion process arm pain, may be due to infusion speed is too fast caused by azithromycin infusion, should control the drip rate, infusion speed is too fast, in addition to may cause arm pain, may also cause vomiting and other side effects appear.

So can azithromycin actually be used in pediatric patients?

Of course it's possible.However, there is a prerequisite that there should be relevant indications for the infection to beAzithromycin is a macrolide antibiotic. Azithromycin is a macrolide antibiotic, and erythromycin, Erythromycin Auxiliary, erythromycin roxithromycin and other drugs belong to a class, for a variety of bacterial infections of the respiratory tract, mycoplasma infections, have a very good therapeutic effect for the mycoplasma infections, azithromycin is the strongest anti-infective effect of the macrolide drugs. Therefore, azithromycin is commonly used for mycoplasma infected pneumonia that children are prone to. In addition, azithromycin also has good anti-infective effects on skin and soft tissue infections caused by sensitive bacteria, pharyngitis, tonsillitis, sinusitis, otitis media, and so on.

Let's briefly talk about the most common application of azithromycin pediatrics - mycoplasma pneumonia. For young children, the general resistance is weak, if there is a cold and cough and other situations occur, there is a greater chance of triggering mycoplasma pneumonia, if the children cough for more than 1~2 weeks, it is best to check the mycoplasma, it is very simple, the blood test can be detected, if it is confirmed to be mycoplasma infections, then no matter whether it is oral or static drip, with azithromycin to fight mycoplasma infections, it is a very symptomatic drug. In this also have to say one more sentence to remind parents and friends, if the pediatric cough one week check Mycoplasma pneumoniae is negative, the second week also continued to cough, may wish to go to the examination again, because mycoplasma can be detected in general 5 to 7 days, also does not exclude 14 days to detect the infection.

How to safely apply azithromycin in pediatric patients

Azithromycin this drug, anti-infection, especially the upper respiratory tract, lower respiratory tract infections are very good, but for pediatric applications, should also pay attention to, to give you the following recommendations for reference -

1. Oral try not to intravenous drip, clear a concept, intravenous drip is not necessarily stronger than oral effect, if the child's infection is not serious, the symptoms are not dangerous, and there is no inability to swallow the situation, then the oral or as far as possible not to choose intravenous drip way to give the drug, oral use of the drug is more secure.

2. Oral medication to pay attention to gastrointestinal side effects, azithromycin is the most common side effects of gastrointestinal side effects, children may vomit, abdominal pain, anorexia, diarrhea and other symptoms after taking the drug, in addition, there may also be rashes, itching and other side effects, in the process of using the drug, be sure to take according to the dosage, according to the course of treatment, do not change the dosage of the drug, and do not discontinue because of disappearance of the symptoms.

3. Intravenous injection pay attention to the drip rate, intravenous injection of azithromycin, in addition to the same may cause gastrointestinal side effects, may also cause some local reactions, such as the above mentioned pediatric arm pain, is the intravenous drip caused by local side effects. Therefore, for such an injection, more attention should be paid to the control of the drip rate, children playing bottles, the general requirements of the control of the drip rate of 20 ~ 40 drops / minute, for the drugs that may produce side effects, such as 500 ml of a bottle of liquid, try to control the drip rate of the drip in 3 ~ 4 hours to finish as well.

1, children can be treated with azithromycin, Mycoplasma pneumoniae, Chlamydia, Chlamydia trachomatis, etc., but also for sensitive bacterial infections.

2, oral azithromycin is best used in children older than 6 months, more safety, injection is best applied to children older than one year.

3, if the arrhythmia of the best is not recommended to use, affect the heart delivery system, easy to aggravate the arrhythmia.

4, azithromycin infusion when the best baby to eat a full meal, at the same time control the infusion speed, reduce azithromycin you gastrointestinal side effects.

5, can oral azithromycin you try to oral, the best choice of imported Xisumi, the efficacy is better, if not serious can be used orally instead of infusion.

6, azithromycin configuration drug concentration is too high, can cause infusion injection site pain feeling, but not a drug side effect, 1 mg per milliliter, you can reduce arm pain during infusion.

7, azithromycin most common side effects gastrointestinal side effects, vomiting abdominal pain diarrhea symptoms, prolonged use is likely to cause liver function abnormalities.

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Dr. Ke is a pediatrician with rich clinical experience, specializing in children's digestive and respiratory diseases, chronic cough, acute and chronic sinusitis, allergic rhinitis, Helicobacter pylori infection, chronic gastritis, functional constipation, liver function abnormalities, chronic diarrhea, milk protein allergy, and other difficult and complicated cases, as well as infant and young child nutritional development and feeding consulting. For more information about pediatrics, please visit Dr. Ke Youjian online. With health as a companion, with the doctor as a friend, welcome to forward the likes, comments and concerns, likes to share is a virtue. If you have any questions, please leave a message and Dr. Ke will answer your typical questions during his breaks.

Available.

Azithromycin is a macrolide antimicrobial drug, which is effective in the treatment of a variety of pathogenic microbial infections, especially for the treatment of mycoplasma infections. And the drug is well tolerated, the incidence of adverse reactions is relatively low, so the drug is gradually promoted in pediatric anti-infective treatment.

According to your description of the child's situation, the child went to the hospital after a cold, and the doctor gave azithromycin on static drip according to the patient's condition, which should not be a problem for a clinical pharmacist to judge the choice of medication used. However, you mentioned that during the infusion of azithromycin, the patient complained of arm pain, which may be related to the adverse reaction of venous pain caused by azithromycin.

So let me explain about venous pain. Azithromycin is a chemically synthesized drug, in the process of infusion of azithromycin will cause chemical stimulation of vascular endothelial cells, platelets or basophils to release histamine and other substances causing infusion of local venous pain. Therefore, in the instructions for azithromycin for injection, there are certain requirements for its concentration and drip rate, generally the quality concentration of azithromycin for intravenous drip is controlled at 1-2g/L, and the highest concentration is not higher than 2g/L. However, there are individual differences between patients, and the drip rate of each patient should be adjusted according to the patient's tolerance, and the drip rate should be slowed down in the initial administration of azithromycin in the general situation, and then adjust the drip rate according to the patient's tolerance. In general, the drip rate should be slowed down at the initial administration, and then adjusted according to the patient's tolerance, which can slow down the stimulation of azithromycin on the gastrointestinal tract and blood vessels at the initial stage of infusion, and can effectively reduce the occurrence of azithromycin adverse reactions. If the concentration of azithromycin is too high and the speed of administration is too fast, the concentration of the drug rises rapidly in a short period of time, thus increasing the incidence and severity of adverse drug reactions. If during the infusion of azithromycin children appear agitation, crying, vomiting and other discomforts, it should be considered that the adverse reaction of the drug, inform the doctor in time, slow down the drip rate as long as it can be tolerated, and can be given a local massage or local hot compresses with appropriate temperature.

I hope my answer is helpful and I wish the child a speedy recovery.

The authoritative interpretation of Pharmaceutical Affairs, unauthorized reproduction, plagiarism will be punished.

Of course. If a child is suspected of having a respiratory tract infection, for example, if there is fever, cough, sputum, and high blood test indicators of infection, it is considered to be a bacterial infection, bacterial pneumonia, which will often be treated empirically with antibiotics, generally preferred penicillin or cephalosporin treatment until the temperature is normalized for 5-7 days. If the use of penicillin or cephalosporin antibiotic treatment for 3 days does not work, we should doubt whether the atypical pathogen infection, such as mycoplasma or chlamydia, if these atypical pathogens infections, then the use of penicillin (eg, amoxicillin, piperacillin, etc.) or cephalosporin (eg, ceftazidime, cefaclor) are ineffective, because this type of antibiotics are required to act on the bacterial cell wall to work. Bacterial cell wall, but atypical pathogens do not have a cell wall, so these antibiotics are useless.

This is the time to use macrolide antibiotics, such as azithromycin, erythromycin, roxithromycin and so on, especially azithromycin, they have inhibitory effect on mycoplasma, spirochetes, rickettsiae, chlamydia and so on, can treat respiratory tract infections caused by these pathogens, usually only need to be taken once a day, adults are 500ml, children are 10mg/kg, usually used for 3 consecutive days. Overall azithromycin is still relatively safe, as long as the adverse effects of the digestive tract, such as vomiting, diarrhea, abdominal pain, etc., a few patients will have a rash.

The child may be uncomfortable if the infusion is given too quickly, at which point it can be slowed down. Generally azithromycin does not irritate the peripheral veins much and can be observed. If the child is really uncomfortable, you will have to inform the nurse so that the infusion can be slowed down or even stopped and continued for observation.

Azithromycin can be used in pediatric patients.

Azithromycin as a kind of antibiotic, in the use of azithromycin and other antibiotics, especially for children to use antibiotics must be strictly grasp the indications for the use of antibiotics, do not abuse antibiotics, to prevent drug resistance, the occurrence of secondary infections.

Azithromycin is mainly used for the treatment of respiratory infections, such as lung infections, bronchial infections and other diseases caused by bacteria, mycoplasma and other microorganisms.

Azithromycin's adverse effects mainly include digestive adverse ranges mainly, such as nausea, vomiting, diarrhea, abdominal discomfort, etc. In addition to gastrointestinal adverse effects Azithromycin can also lead to loss of hearing and tinnitus, deafness occurs.

Here Xiao Ke also need to point out that azithromycin in the use of time, as far as possible, mainly oral, avoid intravenous infusion, because intravenous infusion itself is a kind of invasive treatment, for the children, the body's function development is still not perfect, the occurrence of adverse reactions and other safety events of a greater chance.

Regarding the cause of arm pain after azithromycin infusion, which may mainly be caused by the long infusion time and the fast drip rate of the liquid, you can use a hot towel with wet heat to relieve the symptoms of arm soreness.

I hope the above text can help you, pay attention to Xiao Ke for more health knowledge.

It certainly works, but be aware of the indications.

There are fewer antibiotic options available to children as opposed to adults, which are more common:

• Penicillins: such as the familiar amoxicillin, ampicillin, etc.
• Cephalosporins: for example, the familiar cefoxitin, ceftazidime, cefaclor, etc.
• Macrolide lactones: e.g. erythromycin, azithromycin, etc.
• Others: e.g. uncommon vancomycin, tylenol, etc.

As you can see, azithromycin is more important in the status of antibiotic use in small children.

However, in the actual use of the process, Xiaoguo found that many mothers will have these misunderstandings:

[1] Doctor, I've heard that azithromycin has a big gastrointestinal reaction, can I stop using it?

Yes, erythromycin and azithromycin have a high gastrointestinal response compared to other antibiotics, and many children experience vomiting, abdominal pain, and diarrhea after use.

However, we still have to weigh the pros and cons and use azithromycin if our child's illness requires it.

We can minimize the gastrointestinal reaction by slowing down the infusion and eating something before the infusion.

[2] Doctor, my child was hanged up on azithromycin last time, and every time he has to be hanged up on azithromycin before he gets well, so don't hang up anything else for me, just hang up on azithromycin directly

There are also a lot of parents in this category because a particular pneumonia happened to be caused by atypical bacteria (Mycoplasma pneumoniae, Chlamydia pneumoniae, etc.) and ended up being cured by azithromycin.

In this way, some parents mistakenly believe that their child is only effective on azithromycin.

Then, every time you have a cough, you take your own oral azithromycin or ask your doctor to hook up an azithromycin shot.

This is also wrong.

And when do you use azithromycin?

• Infections caused by atypical bacteria, including Chlamydia pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila.
  
• Others such as Haemophilus influenzae can also work, but are clearly not preferred given the gastrointestinal side effects of azithromycin

Look a little deep is not it, to put it bluntly, this is in the clinic, a medical student after five years of medical classroom learning, three years of regulation training practice, there is no guarantee that independent visits to the patient can grasp the correct use of antibiotics.

And as an average mom or dad without any medical foundation, it's better to honestly listen to your doctor and use it when you should and not when you shouldn't.

But, as a new age mom and dad, it is also necessary to know some basic medical knowledge so that you can distinguish those doctors who are more reliable, and also be able to listen and understand when communicating with them to ease your anxiety.

I'm Dr. Xiaoguo, an attending pediatrician at a tertiary hospital, mother of two babies, and have been practicing medicine for more than ten years, so welcome to pay attention to learn more about parenting.

Children are not unable to use azithromycin, oral azithromycin can be used, but intravenous azithromycin because of its instructions do not mention the information related to children's use of the drug, belongs to the empirical over-the-subscription of the drug, before the use of the drug is to inform the parents of the child and to obtain the consent of the parents of the child.

Azithromycin side effects are mainly gastrointestinal reactions, with the drug baby will have stomach pain, vomiting and other symptoms, in addition, azithromycin and liver and kidney function damage.

So let's learn more about Azithromycin.

[Indications

Acute pharyngitis and acute tonsillitis caused by Streptococcus pyogenes. Sinusitis, acute otitis media, acute bronchitis, acute exacerbation of chronic bronchitis caused by sensitive bacteria. Pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae. Urethritis and cervicitis caused by Chlamydia trachomatis and non-multi-drug resistant Neisseria gonorrhea. Soft tissue skin infections caused by sensitive bacteria.

[Usage and dosage]

Take orally, 1 hour before or 2 hours after a meal.

Adult dosage: for sexually transmitted infections caused by Chlamydia trachomatis or Neisseria gonorrhoeae, a single oral dose of 1.0 g is required.For other infections: 0.5 g at once on day 1, 0.25 g at once on days 2-5, or 0.5 g at once on day 1 for 3 consecutive days.

Pediatric dosage: For the treatment of otitis media and pneumonia, 10 mg/kg of body weight should be taken at once on the first day (the maximum amount should not exceed 0.5 g per day), and 5 mg/kg of body weight should be taken at once on the second and fifth days (the maximum amount should not exceed 0.25 g per day). For the treatment of pharyngitis and tonsillitis in children, 12 mg/kg of the drug should be taken at once daily (the maximum amount should not exceed 0.5 g per day) for 5 consecutive days.

Pediatric can't use azithromycin should mean that you can't just apply intravenous azithromycin, right, because of its gastrointestinal own liver and kidney function damage and other side effects.

I am Huaishan, specializing in children's health knowledge. Welcome to like and follow.

Sure.

Azithromycin is a macrolide antibiotic, which is widely used in the clinic, and like erythromycin, roxithromycin and clarithromycin, it has a good effect on tonsillitis, pharyngitis, bronchitis and pneumonia caused by bacterial infections and mycoplasma infections.

Generally, azithromycin is available in two forms: injection and tablet. The injections are usually used during infusion, while the tablets are used orally, and both are very safe. However, azithromycin also has a significant side effect that is common to all macrolides - it causes digestive discomfort, especially in the stomach.

In addition to being available in pediatrics, Azithromycin is, in fact, perfectly fine to use during pregnancy and breastfeeding.

Azithromycin is classified as a Class B drug according to the Pregnancy Drug Classification, which means that azithromycin has shown no significant side effects or teratogenicity in pregnant animals in animal studies, as well as no similar side effects in human studies.

In breastfeeding medication, azithromycin is an L2 medication and is based on essentially the same principles as pregnancy medication.

Apart from azithromycin, of all the antibiotics, nitroimidazoles, cephalosporins and penicillin are also very safe, especially penicillin, which basically does not have any effect on pregnancy or not as well. The worst antibiotics, on the other hand, are the tetracyclines and quinolones, which should be completely banned.

Azithromycin injection gastrointestinal reaction is more serious, some patients drip to half began to vomit, older instead of reacting to powerful, although the prescription has antiemetic drugs. There is another case, there is a peer, his good friend's daughter home on vacation from college sick, was found to have mycoplasma infection, because the relationship is good, it went to the friend's home to the infusion of azithromycin, as a result of this doctor returned home soon after the patient died. It seems that the reported damage to the heart is worth the attention of all doctors!