Table of ContentsView AllTable of ContentsConditions TreatedFormulationsDosageSide EffectsDrug InteractionsWarnings
Table of ContentsView All
View All
Table of Contents
Conditions Treated
Formulations
Dosage
Side Effects
Drug Interactions
Warnings
Zithromax (azithromycin)is anantibioticthat can be used to treat ear and sinus infections, pneumonia, strep throat, and other bacterial infections in children. It is approved for children 6 months or older and is a good option for kids withpenicillin allergies.
Guidelines for pediatric dosing of azithromycin are based on the condition being treated and the weight of the child. The drug is available in pill or liquid form.
This article discusses the use of azithromycin in kids, including how it is taken, possible side effects, and drug interactions.
Benefits of Azithromycin for Children
Zithromax is an oral antibiotic first licensed for use in 1991 for the treatment of certain mild to moderatebacterial infections.
Zithromax is often used off-label for other mild to moderate bacterial infections, including those that causewalking pneumoniaandpertussis (whooping cough).
Why Is Azithromycin Not Prescribed First?Due to increasing rates of azithromycin resistance, Zithromax is not the first drug generally used to treat bacterial infections. It is more commonly prescribed when a first-line option likepenicillinorAmoxil (amoxicillin)fails to clear an infection or cannot be used due to allergy.Studies suggest that rates of azithromycin resistance toStaphylococcus aureusandStreptococcus pneumoniaeare as high as 48% and 68% in the United States.
Why Is Azithromycin Not Prescribed First?
Due to increasing rates of azithromycin resistance, Zithromax is not the first drug generally used to treat bacterial infections. It is more commonly prescribed when a first-line option likepenicillinorAmoxil (amoxicillin)fails to clear an infection or cannot be used due to allergy.Studies suggest that rates of azithromycin resistance toStaphylococcus aureusandStreptococcus pneumoniaeare as high as 48% and 68% in the United States.
Due to increasing rates of azithromycin resistance, Zithromax is not the first drug generally used to treat bacterial infections. It is more commonly prescribed when a first-line option likepenicillinorAmoxil (amoxicillin)fails to clear an infection or cannot be used due to allergy.
Studies suggest that rates of azithromycin resistance toStaphylococcus aureusandStreptococcus pneumoniaeare as high as 48% and 68% in the United States.
Z-Pak for Sinus Infection: Is It Necessary?
Forms of Azithromycin for Kids
Zithromax is a macrolide antibiotic, a class of antibiotics that also includeserythromycin, clarithromycin, fidaxomicin, and telithromycin. Macrolide antibiotics are regarded as broad-spectrum antibiotics because they act against a wide range of bacteria.
Zithromax has long been considered attractive to kids because it is well-tolerated, inexpensive, can be taken with or without food, and often requires only a single dose to clear an infection. (However, overuse of the drug has led to widespread resistance in which bacteria once susceptible to the drug are no longer affected.)
Zithromax is available in several formulations and dosed in milligrams (mg):
Zithromax is a good choice for children who are allergic to penicillin.
Azithromycin Pediatric Dosages
Zithromax is taken once daily with a course of one or several doses. When used in children, the dosage is calculated based on milligrams per kilogram of body weight (mg/kg).
For instance, if a child weighs 10 kilograms and the dose is 10 mg/kg, the child would be prescribed 100 milligrams (10 mg x 10 kg = 100 mg).
Otitis Media
Otitis media, also known as a middle ear infection, is common in young children because the size and shape of their smaller ear canals can easily trap fluids and germs.
Acute Bacterial Sinusitis
The recommended dosage in children 6 months and over is:
Community-Acquired Pneumonia
Community-acquired pneumonia (CAP)is pneumonia that is caught and spread outside a hospital or other healthcare or nursing facility.Streptococcus pneumoniaeis the most common cause of CAP, accounting for roughly 50% of cases.Influenza virus Ais another common cause.
Pharyngitis or Tonsillitis
Pharyngitisis inflammation of thepharynx(throat) andtonsillitisis inflammation of thetonsils. The most common bacterial cause isStreptococcal pyogenes,the bacteria that causes strep throat. Strep throat accounts for roughly 30% of sore throats in kids,
The recommended dosage in children 2 years and over is:
How to Give Zithromax to KidsIf you miss a dose, give it as soon as you remember unless the next dose is within 12 hours. In such a case, skip the dose and give your child the next dose as usual. Never double up on doses as this can increase the risk of side effects.It doesn’t matter what time of day Zithromax is taken, but you should give it around the same time every day. All doses should be given even if your child is feeling better.
How to Give Zithromax to Kids
If you miss a dose, give it as soon as you remember unless the next dose is within 12 hours. In such a case, skip the dose and give your child the next dose as usual. Never double up on doses as this can increase the risk of side effects.It doesn’t matter what time of day Zithromax is taken, but you should give it around the same time every day. All doses should be given even if your child is feeling better.
If you miss a dose, give it as soon as you remember unless the next dose is within 12 hours. In such a case, skip the dose and give your child the next dose as usual. Never double up on doses as this can increase the risk of side effects.
It doesn’t matter what time of day Zithromax is taken, but you should give it around the same time every day. All doses should be given even if your child is feeling better.
Azithromycin Side Effects in Kids
Verywell / Brianna Gilmartin
For children taking a five-day course of Zithromax, the most common side effects include:
When prescribed as a one-time dose, there is a greater risk of vomiting or diarrhea. If the side effects are severe or persistent, call your healthcare provider.
On rare occasions, a child may experience a severe and potentially life-threatening allergy known asanaphylaxis.
When to Call 911Call 911 or seek emergency care if your child experiences shortness of breath, wheezing, rapid heart rate, dizziness, vomiting, or swelling of the face, tongue, or throat after taking Zithromax.
When to Call 911
Call 911 or seek emergency care if your child experiences shortness of breath, wheezing, rapid heart rate, dizziness, vomiting, or swelling of the face, tongue, or throat after taking Zithromax.
Azithromycin Interactions
Always advise your pediatrician about any drugs your child may be taking, whether pharmaceutical, over-the-counter, nutritional, homeopathic, or traditional.
Azithromycin Warnings
The FDA warns that azithromycin can cause changes in the heart’s regular electrical activity, leading to an abnormal heart rhythm condition known asQT interval prolongation. This can cause fast or irregular heartbeats, severe dizziness, blurred vision, fainting, and death (rare).
Certain factors can increase a child’s risk while taking Zithromax:
Call your healthcare provider if your child experiences irregular heartbeats or has a sudden dizziness spell. If there is fainting, take your child to the emergency room, even if it lasts for only a few seconds.
Summary
Zithromax (azithromycin) is an oral antibiotic that can be used in children to treat a middle ear infection, sinus infection, pneumonia, strep throat, and tonsillitis. Depending on the condtion being treated, it may be given over one to five days. The dose is calculated based on the child’s weight in kilograms. Common side effects include upset stomach, diarrhea, and nausea.
Antibiotic Prescribing Guidelines in Children
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Centers for Disease Control and Prevention.Antibiotic class definitions.
National Institute on Deafness and Other Communication Disorders.Ear infections in children.
American College of Allergy, Asthma & Immunology.Sinus Infection. 2024.
Metlay JP, Waterer GW, Long AC, et al.Diagnosis and treatment of adults with community-acquired pneumonia. An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America.Am J Respir Crit Care Med. 2019;200(7):e45-e67. doi:10.1164/rccm.201908-1581ST
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MedlinePlus.Azithromycin.
U.S. Food and Drug Administration.FDA drug safety communication: azithromycin (Zithromax or Zmax) and the risk of potentially fatal heart rhythms.
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