What are the dangers of azithromycin overdose?

Azithromycin is a commonly used macrolide antibiotic, available in various formulations such as tablets and capsules. Generally, excessive use of azithromycin can have adverse effects on multiple body systems. The main risks include worsening gastrointestinal discomfort, liver function damage, cardiac toxicity, exacerbated neurological symptoms, and hearing impairment. A detailed analysis is as follows:

1. Worsening gastrointestinal discomfort: Nausea and vomiting may occur even at normal doses. Overuse can significantly aggravate these reactions, leading to frequent vomiting, severe abdominal pain, and watery diarrhea. In serious cases, this may result in dehydration, electrolyte imbalances, impaired digestive and absorptive functions of the gastrointestinal tract, and even mucosal damage.

2. Liver function damage: As the drug is metabolized by the liver, excessive use increases the metabolic burden on this organ, potentially causing hepatocellular injury. This may manifest as abnormal liver function tests, accompanied by symptoms such as fatigue, jaundice (yellowing of the skin or eyes), and darkened urine. Individuals with pre-existing liver disease face a higher risk of liver injury when overdosing.

3. Cardiac toxicity: Excessive use may interfere with cardiac electrophysiological activity, prolonging the QT interval and increasing the risk of arrhythmias. Symptoms may include palpitations, chest tightness, and dizziness. In severe cases, it may trigger torsades de pointes, a life-threatening form of ventricular tachycardia, thereby damaging heart function.

4. Exacerbation of neurological symptoms: While some individuals may experience dizziness or headache at normal doses, these symptoms can become significantly worse with overdose. Additional manifestations may include restlessness, drowsiness, difficulty concentrating, and, rarely, seizures or confusion—indicating serious neurological reactions that impair normal nervous system function.

5. Hearing impairment: Overuse may irritate or damage the auditory nerves, resulting in hearing loss, tinnitus, or a sensation of fullness in the ears. In most cases, hearing damage is temporary and gradually resolves after discontinuation of the drug; however, severe overdose may increase the risk of permanent hearing loss.

When using azithromycin, it is important to observe contraindications and precautions, strictly adhere to prescribed dosages and treatment durations as directed by a healthcare provider or as indicated in the medication leaflet, and avoid increasing the dose or extending the duration of use without medical advice. If any unusual discomfort occurs during treatment, discontinue the drug promptly and monitor bodily changes closely to ensure safe medication use.