What are the precautions for using azithromycin injection?

Under normal circumstances, the use of azithromycin injection must strictly follow established guidelines. Key precautions include allergy screening, proper administration methods, strict control of dosage and treatment duration, awareness of drug interactions, and suitability for special populations. A detailed analysis is as follows:

1. Allergy Screening: It is essential to determine whether the patient has a history of allergy to azithromycin or other macrolide antibiotics before administration. The drug is contraindicated in allergic individuals. Close monitoring of the patient's response is required during initial administration. If signs of allergic reaction occur—such as rash, itching, or difficulty breathing—the drug should be discontinued immediately and appropriate interventions initiated.

2. Proper Administration Method: The drug should only be administered via intravenous infusion; intramuscular injection or direct intravenous bolus injection is strictly prohibited. Infusion rate must be carefully controlled: when the concentration is 1 mg/mL, the infusion should last no less than 3 hours; when the concentration is 2 mg/mL, the infusion should last no less than 1 hour. Rapid infusion should be avoided to prevent adverse reactions.

3. Strict Control of Dosage and Duration: Dosage should be adjusted based on the type of infection, patient age, and body weight, with clear differences between adult and pediatric doses—dosages should not be arbitrarily increased or decreased. The typical treatment course lasts 3–5 days; extension beyond this requires physician evaluation. Excessive dosing may increase the burden on the liver and kidneys and lead to adverse effects.

4. Drug Interactions: Avoid concomitant use with drugs that prolong the QT interval, such as certain antiarrhythmics and antihistamines, as this may increase the risk of cardiac adverse events. When used with warfarin, coagulation function should be closely monitored to prevent increased bleeding risk. Concomitant use with other hepatotoxic drugs is not recommended.

5. Use in Special Populations: Pregnant and breastfeeding women should only use the drug after physician evaluation and when potential benefits outweigh risks. Patients with hepatic impairment should receive reduced doses; the drug is contraindicated in those with severe liver dysfunction. Dose adjustment is generally not required for patients with renal impairment, but renal function should be monitored regularly.

During treatment, regular monitoring of liver and kidney function and electrocardiograms (ECG) is recommended. Watch for symptoms such as gastrointestinal discomfort or dizziness. A light, easily digestible diet is advised; spicy or irritating foods should be avoided. Adequate fluid intake is important to promote drug metabolism.