What is a Z-Pak antibiotic. How does azithromycin work against bacterial infections. When should you use a Z-Pak for treatment. What are the potential side effects and risks of taking azithromycin. How effective is Z-Pak compared to other antibiotics for various conditions.

Understanding Z-Pak: A Powerful Antibiotic Treatment

Z-Pak, also known as Zithromax, is a popular brand name for the antibiotic azithromycin. As one of the most frequently prescribed antibiotics in the United States, azithromycin belongs to the macrolide class of antibiotics. Its primary function is to combat bacterial infections by inhibiting bacterial growth, earning it the classification of a “bacteriostatic” antibiotic.

Unlike antibiotics that directly kill bacteria, Z-Pak works by preventing bacteria from multiplying. This mechanism allows the body’s natural immune system to more effectively eliminate the remaining bacteria. It’s crucial to note that Z-Pak is ineffective against viral infections, including COVID-19, common colds, viral bronchitis, and most sinus infections.

How does Z-Pak differ from other antibiotics?

Z-Pak stands out from other antibiotics due to its unique mechanism of action and convenient dosing schedule. While many antibiotics require multiple doses per day for 7-14 days, Z-Pak is typically prescribed as a 5-day course with a single daily dose. This shorter treatment duration can improve patient compliance and reduce the risk of antibiotic resistance.

Common Uses of Z-Pak in Medical Practice

Z-Pak is prescribed for a variety of bacterial infections affecting different parts of the body. Here are some of the most common conditions treated with azithromycin:

• Strep throat (in penicillin-allergic patients)
• Community-acquired pneumonia
• Bacterial bronchitis
• Bacterial sinusitis
• Tonsillitis
• Ear infections (otitis media)
• Mycobacterium Avium Complex (MAC) lung disease
• Non-gonococcal urethritis
• Pelvic Inflammatory Disease (PID)
• Cervicitis
• Early-stage Lyme disease (in patients who cannot tolerate other antibiotics)

Is Z-Pak effective for strep throat?

For patients with penicillin allergies, Z-Pak has proven to be an effective alternative in treating strep throat. Research indicates that azithromycin is just as efficacious as penicillin for strep throat treatment in these cases. However, it’s important to remember that Z-Pak is not effective against viral throat infections, which are more common than bacterial ones.

Z-Pak and Respiratory Infections: A Closer Look

Respiratory infections are among the most common reasons for Z-Pak prescriptions. Let’s examine its effectiveness in treating various respiratory conditions:

How does Z-Pak perform in treating pneumonia?

Z-Pak has shown promising results in treating certain types of community-acquired pneumonia. Studies have revealed that patients treated with azithromycin often experience shorter hospital stays, despite a briefer course of antibiotics. In some cases, healthcare providers may combine Z-Pak with another antibiotic for a more potent effect, as azithromycin alone may not be effective against all pneumonia-causing bacteria.

Can Z-Pak effectively treat bronchitis?

While Z-Pak can be useful in cases of bacterial bronchitis, it’s important to note that most bronchitis cases are viral in nature. A study published in American Family Physician demonstrated that antibiotics, including Z-Pak, provide minimal benefit in most acute bronchitis cases. However, for bronchitis caused by specific bacteria like those responsible for whooping cough, Z-Pak can be effective in reducing the spread of infection.

Z-Pak for Genitourinary and Sexually Transmitted Infections

Azithromycin plays a role in treating several genitourinary and sexually transmitted infections, though it’s not always the first-line treatment. Here’s an overview of its applications in this area:

How effective is Z-Pak for non-gonococcal urethritis?

Z-Pak can effectively treat non-gonococcal urethritis, particularly when it’s caused by chlamydia. However, doxycycline is often the preferred antibiotic for this condition. Azithromycin serves as an alternative when doxycycline cannot be used.

What role does Z-Pak play in treating Pelvic Inflammatory Disease (PID)?

While doxycycline is the primary antibiotic recommended for PID treatment, Z-Pak can be used in combination with another antibiotic for patients who cannot tolerate doxycycline. This combination approach ensures broader coverage against the various bacteria that can cause PID.

Z-Pak Dosage and Administration

The typical Z-Pak regimen consists of a 5-day course of treatment. Here’s a breakdown of the standard dosing schedule:

1. Day 1: 500 mg (2 tablets of 250 mg)
2. Days 2-5: 250 mg (1 tablet) daily

This unique dosing schedule sets Z-Pak apart from many other antibiotics, potentially improving patient compliance and reducing the risk of antibiotic resistance.

How should Z-Pak be taken for optimal effectiveness?

To maximize the effectiveness of Z-Pak, it’s crucial to follow these guidelines:

• Take the medication at the same time each day
• Complete the entire course of antibiotics, even if symptoms improve before the medication is finished
• Z-Pak can be taken with or without food, but taking it with food may help reduce stomach upset
• Avoid taking antacids containing aluminum or magnesium within 2 hours before or after taking Z-Pak, as they can interfere with absorption

Potential Side Effects and Risks of Z-Pak

While Z-Pak is generally well-tolerated, like all medications, it can cause side effects in some patients. Understanding these potential risks is crucial for safe and effective treatment.

What are the most common side effects of Z-Pak?

The most frequently reported side effects of Z-Pak include:

• Nausea and vomiting
• Diarrhea
• Abdominal pain
• Headache
• Dizziness
• Fatigue

These side effects are typically mild and resolve on their own. However, if they persist or worsen, it’s important to consult a healthcare provider.

Are there any serious risks associated with Z-Pak use?

While rare, Z-Pak can cause more serious side effects in some individuals. These include:

• Allergic reactions (rash, itching, swelling, severe dizziness, trouble breathing)
• Irregular heartbeat or prolonged QT interval
• Severe diarrhea (potentially caused by C. difficile infection)
• Liver problems (yellowing of skin/eyes, dark urine, persistent nausea/vomiting, abdominal pain)
• Hearing changes or ringing in the ears

Patients experiencing any of these symptoms should seek immediate medical attention.

Z-Pak vs. Other Antibiotics: Comparative Effectiveness

When prescribing antibiotics, healthcare providers consider various factors, including the specific bacterial infection, patient allergies, and potential drug interactions. Let’s compare Z-Pak’s effectiveness to other commonly prescribed antibiotics for various conditions:

How does Z-Pak compare to penicillin for strep throat?

For patients without penicillin allergies, penicillin remains the gold standard for treating strep throat due to its effectiveness and low cost. However, studies have shown that Z-Pak is equally effective in treating strep throat in penicillin-allergic patients, making it a valuable alternative.

Is Z-Pak more effective than amoxicillin for sinus infections?

While Z-Pak can be used to treat bacterial sinusitis, amoxicillin or amoxicillin-clavulanate is generally preferred. A study comparing the impact of amoxicillin-clavulanate and azithromycin found that both antibiotics were effective, but amoxicillin-clavulanate showed slightly better results in some cases.

How does Z-Pak compare to doxycycline for chlamydia?

Both Z-Pak and doxycycline are effective in treating chlamydial infections. However, doxycycline is often the preferred treatment due to its broader spectrum of activity and potentially lower risk of developing antibiotic resistance. Z-Pak remains a valuable alternative for patients who cannot tolerate doxycycline.

Antibiotic Resistance and Z-Pak: Important Considerations

As with all antibiotics, there are concerns about the development of resistance to Z-Pak. Antibiotic resistance occurs when bacteria evolve to become less susceptible to the effects of antibiotics, making infections harder to treat.

How can we prevent antibiotic resistance related to Z-Pak use?

To minimize the risk of antibiotic resistance, it’s crucial to follow these guidelines:

• Only use Z-Pak when prescribed by a healthcare provider for confirmed bacterial infections
• Complete the entire course of antibiotics, even if symptoms improve before the medication is finished
• Never share antibiotics with others or use leftover antibiotics from previous infections
• Practice good hygiene to prevent the spread of infections
• Stay up-to-date with vaccinations to reduce the need for antibiotics

Healthcare providers play a crucial role in preventing antibiotic resistance by prescribing Z-Pak and other antibiotics judiciously, based on confirmed bacterial infections and local resistance patterns.

Special Populations and Z-Pak Use

While Z-Pak is generally safe and effective for many patients, special considerations apply to certain populations. Understanding these nuances is crucial for safe and effective treatment.

Is Z-Pak safe for use during pregnancy?

Z-Pak is classified as a Pregnancy Category B drug, meaning that animal studies have not shown a risk to the fetus, but there are no adequate studies in pregnant women. While generally considered safe, Z-Pak should only be used during pregnancy when the potential benefits outweigh the risks. Pregnant women should consult their healthcare provider before taking any antibiotics.

Can Z-Pak be used in pediatric patients?

Z-Pak is approved for use in children, but the dosage is typically based on the child’s weight. For certain conditions, such as community-acquired pneumonia in children, Z-Pak has shown to be effective and well-tolerated. However, as with adults, it’s crucial to use Z-Pak only when necessary to prevent the development of antibiotic resistance.

Are there any special considerations for elderly patients taking Z-Pak?

Elderly patients may be more susceptible to certain side effects of Z-Pak, particularly those related to heart rhythm disturbances. Healthcare providers may need to adjust dosages or monitor these patients more closely. Additionally, potential drug interactions should be carefully considered, as older adults are more likely to be taking multiple medications.

When to Seek Medical Attention

While Z-Pak can effectively treat many bacterial infections, it’s crucial to know when to seek medical attention. Here are some situations that warrant a consultation with a healthcare provider:

• Persistent or worsening symptoms despite completing a course of antibiotics
• Development of new symptoms or side effects while taking Z-Pak
• Signs of an allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing)
• Severe or persistent diarrhea, which could indicate a C. difficile infection
• Symptoms of liver problems (yellowing of skin/eyes, dark urine, persistent nausea/vomiting, abdominal pain)
• Irregular heartbeat or prolonged QT interval
• Any unusual or severe reactions while taking the medication

Remember, Z-Pak and other antibiotics should only be used under the guidance of a healthcare professional. Self-diagnosis and self-medication can lead to inappropriate antibiotic use, contributing to the global problem of antibiotic resistance.

Future Directions in Antibiotic Treatment

As antibiotic resistance continues to be a global health concern, researchers are exploring new approaches to combat bacterial infections. Some promising areas of research include:

What new antibiotic alternatives are being developed?

Scientists are investigating several innovative approaches to fight bacterial infections:

• Bacteriophage therapy: Using viruses that specifically target harmful bacteria
• Antimicrobial peptides: Natural or synthetic compounds that can kill bacteria
• CRISPR-Cas systems: Gene-editing technology to target specific bacterial genes
• Nanoparticle-based treatments: Using nanotechnology to deliver antibiotics more effectively
• Antivirulence strategies: Targeting bacterial virulence factors rather than killing bacteria directly

These emerging technologies may provide new tools to combat bacterial infections, potentially reducing our reliance on traditional antibiotics like Z-Pak in the future.

How might personalized medicine impact antibiotic prescribing?

Advances in genomics and diagnostic technologies are paving the way for more personalized approaches to antibiotic treatment. In the future, healthcare providers may be able to:

• Rapidly identify specific bacterial strains causing an infection
• Predict antibiotic susceptibility based on bacterial genetics
• Tailor antibiotic choices and dosages based on a patient’s genetic profile
• Monitor treatment effectiveness in real-time using advanced diagnostics

These advancements could lead to more targeted and effective use of antibiotics like Z-Pak, potentially reducing the risk of antibiotic resistance and improving patient outcomes.

As our understanding of bacterial infections and antibiotic resistance evolves, so too will our approaches to treatment. While Z-Pak remains a valuable tool in our antibiotic arsenal, responsible use and ongoing research are crucial to preserving its effectiveness for future generations.

What is a Z-Pak? Side Effects and More

Zithromax, sometimes called Z-Pak, is a popular form of the antibiotic azithromycin. Azithromycin is the most commonly prescribed antibiotic in the United States.

It is a macrolide antibiotic that treats some bacterial infections by stopping the growth of the bacteria. This process of stalling bacteria growth is why Z-Pak is called “bacteriostatic”—instead of killing bacteria outright, it stops them from growing and multiplying.

The body’s natural defenses can then remove what’s left of the bacteria. Azithromycin has no use in treating viral infections, including COVID-19, common colds, viral bronchitis, or most sinus infections. If you’re wondering what a Z-Pak (or Z-Pack) is, how to use this medication, or whether it’s effective, this guide will help.

In this article, I’ll discuss the Z-Pak’s uses, doseage, and effectiveness, as well as risks and side effects. I’ll talk about when not to take a Z-Pak, and some alternatives to Zithromax. I’ll finish by outlining when you should see a doctor about your symptoms.

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Z-Pak Uses

Azithromycin (Zithromax or Z-Pak) can be used to treat some bacterial infections of the skin, respiratory, and genitourinary system. Here are some infections for which your doctor may prescribe a Z-Pak.

Strep Throat

Strep throat, or streptococcal pharyngitis, is a bacterial infection of the throat. It typically manifests as a sore throat, pain with swallowing, as well as a fever or a rash.

Penicillin antibiotics are the preferred treatment for strep throat, but some patients are allergic to these antibiotics. In these cases, your doctor may prescribe Zithromax instead. Research has shown that Z-Paks treat strep throat just as well as penicillin for those with a penicillin allergy. Azithromycin does not work for viral throat infections.  

Pneumonia

Z-Pak is also effective for treating some types of community-acquired pneumonia, an acute respiratory infection contracted outside of the hospital. Studies show that for patients treated with azithromycin, hospital stays were shorter despite a shorter course of antiobiotics. 

Your provider may also choose to treat pneumonia with a combination of Z-Pak and another antibiotic for a stronger effect, as azithromycin does not treat all types of pneumonia well. Azithromycin does not work for COVID-19 pneumonia or other viral pneumonias.

Bronchitis

Bronchitis is an infection of the main chest airways called bronchi. While most bronchitis is caused by viruses, the infection is sometimes caused by bacteria. In these bacterial cases, Z-Pak may be useful for treatment. 

Most of the time, though, your doctor will probably not prescribe an antibiotic for bronchitis: A study in American Family Physician showed that antibiotics provide very little benefit in most cases of acute bronchitis.

However, when the bronchitis is caused by whooping cough or other specific bacteria, macrolides like Z-Pak are efficient for reducing the spread. 

Other Uses

Other bacterial infections that can be managed with azithromycin are:

• Bacterial sinusitis: According to a study comparing the impact of amoxicillin-clavulanate and azithromycin, Z-Packs can treat sinus infections caused by bacteria. However, most sinus infections are caused by viruses, and do not need antibiotics at all. And when sinusitis is caused by bacteria, other antibiotics are generally preferred and more effective.

• Tonsillitis: Z-Pak works for treating tonsillitis in adults and children who cannot take penicillin-based antibiotics, though it may have more side effects.

• Ear infections (otitis media): Azithromycin is also effective for treating infections of the middle ear that are caused by bacteria in those who cannot take other preferred antibiotics.  

• Mycobacterium Avium Complex (MAC) Lung Disease: Z-Pak is used to manage MAC lung disease, often seen in patients with HIV.

• Non-gonococcal urethritis: This inflammation of the male urethra, caused by the sexually-transmitted disease chlamydia, can be treated with azithromycin, though doxycycline is often the preferred antibiotic.

• Pelvic Inflammatory Disease (PID): PID should be treated with the antibiotic doxycycline, but in those who cannot take doxycycline, azithromycin may be used in combination with another antibiotic. 

• Cervicitis: Experts recommend either doxycycline or azithromycin for the treatment of chlamydial cervicitis, though doxycycline is the recommended treatment. When cervicitis is caused by gonorrhea, a different antibiotic is required.

• Lyme disease: The CDC recommends that people with early Lyme disease who cannot tolerate doxycycline, cefuroxime, or amoxicillin be treated with azithromycin—although it is less effective than the other three in this case.

Dosage of Zithromax

Azithromycin comes in various dosages, but a Z-Pak is a specific, five-day course of azithromycin. The Z-Pak contains six tablets, each containing 250 mg of azithromycin.

Two tables are taken on the first day (for a 500 mg dose), followed by one 250 mg tablet taken each of the next four days. This is a common dose for many types of infections. Azithromycin is available as oral tablets, oral suspension (liquid), and injections or intravenous (IV) medication.

Each of the available forms come in several strengths. 

• Oral tablets: Available as 250 mg and 500 mg tablets.
• Oral suspension: Available as 100 mg/5 mL and 200 mg/5 mL suspensions.
• Injection and IV: Available as 10 mL vial of 500 mg.

Your doctor will decide what dosage is appropriate for you depending on your age and the infection. The prescribed strength and form may also vary over the course of your treatment.  

For example, the recommended dose for strep throat is 500 mg oral tablets once on the first day, followed by 250 mg oral tablets for the next four days. But for non-gonococcal urethritis, it’s a one-time, 1000 mg dose. 

How Long to Take It

Take your azithromycin for the duration prescribed by your provider. Usually, this is between 3-10 days. Make sure to take the medication on time and complete the full treatment course before discontinuing the drug—even if you’ve begun to feel better. 

Starting and quitting the drug before the specified day can cause bacteria to become resistant to antibiotics.

Effectiveness of Azithromycin

Azithromycin is a versatile and highly effective antibiotic when used appropriately. It works well in treating a wide range of bacterial infections both in children and adults. 

Azithromycin is especially effective in treating some sexually transmitted infections, like chlamydia and chlamydia-related infections. One clinical showed that azithromycin showed a 98% eradication for chlamydia and other bacteria.  

Possible Risks and Side Effects of Azithromycin

The most common side effects of azithromycin are not life-threatening for most people. Still, it’s worth knowing what they are so you don’t panic, and can get help from your doctor if needed.

Side effects you may experience with azithromycin are:

• Upset stomach
• Loose stools or diarrhea
• Nausea
• Vomiting
• Dizziness or fainting
• Skin rash 
• Abdominal pain
• Vaginal itchiness from yeast overgrowth
• Headache
• Ringing ears
• Blurred vision
• Nervousness
• Liver problems

Drug Interactions

Azithromycin may interact with several other medications, causing them to be ineffective, or potentially causing serious side effects. Be sure to mention all your current medications to your prescriber before receiving a prescription for azithromycin.

A few drugs that interact with azithromycin are:

• Antidepressants
• Antipsychotic medications
• Anti-malarial medications 
• Heart rhythm medications
• Cholesterol-reducing medication
• Blood pressure medication
• Anti-diarrheal medications 
• HIV medicines

If you take any of these medications, your provider may need to prescribe alternative medication or recommend pausing them for the duration of your antibiotic treatment.

When to Not Take Azithromycin

In some cases, azithromycin is not the right choice. Here are some situations in which you should avoid azithromycin.

STIs

While azithromycin works for treating some sexually transmitted infections, specifically those caused by chlamydia, it should not be used to treat gonorrhea and syphilis, or trichomonas. 

The CDC recommends using ceftriaxone (Rocephin) injection to treat gonorrhea and benzathine penicillin (Bicillin) injections for syphilis.

The CDC also now recommends doxycycline as the first-line treatment for chlamydia, not azithromycin. If you have an allergy or other inability to take doxycycline, then azithromycin may be used.

Age

Children under six months of age should not be treated with azithromycin. Recent studies show that azithromycin is safe for use in the elderly.

Pregnant

While azithromycin does not cause fetal malformations in the uterus, it has been associated with an increased risk of miscarriage.  

Heart Problems

If you have heart problems—especially irregular heartbeats like QT prolongation—it would also be best to avoid using azithromycin. A study in the New England Journal of Medicine showed that use of the antibiotic increased the risk of sudden death linked to heart arrhythmias.

Viral Illnesses

Many common infections, including colds, sinus infections, bronchitis, and some ear and throat infections, are caused by viruses. Unfortunately, when your illness is caused by a virus, an antibiotic will not help at all, and can cause uncomfortable or serious side effects. 

Alternatives to Azithromycin

For those unable to use azithromycin or other macrolides such as erythromycin and clarithromycin, there are other antibiotics you can be prescribed instead.

Amoxicillin

Amoxicillin is a penicillin-like antibiotic that treats many of the same bacterial infections azithromycin does. Because of antibiotic resistance, it is sometimes used with clavulanate as amoxicillin-clavulanate (Augmentin).  

This broad-spectrum antibiotic treats everything from respiratory tract infections to gastrointestinal infections. And it is safe for most people, including those who are pregnant.

Doxycycline

Doxycycline (Monodox) is especially useful for urogenital infections such as chlamydia. Some studies have shown it to be more effective than azithromycin, and the CDC now recommends doxycycline as the first-line treatment for sexually transmitted infections caused by chlamydia. 

Ceftriaxone

Ceftriaxone (Rocephin) treats bacterial pneumonias, ear infections, and throat infections, and may be used instead of, or in addition to, azithromycin for some types of infections.

Your doctor or healthcare provider will make the best choice for you when they know which medications you’re on and which other medical conditions you have.

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When to See a Doctor

If you have worrying signs of an infection, it’s best to see your primary care physician before beginning antibiotic treatment using azithromycin. Many common infections are actually viral, and will resolve on their own without antibiotics.

Azithromycin is not the right treatment for all types of bacterial infections. Your provider can determine if antibiotics are needed at all, which antibiotics are safe and effective for your infection, and what dosage will work best.

If you have already begun using azithromycin and are not seeing improvement in your symptoms or are getting worse, speak to your healthcare provider.

How K Health Can Help

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Frequently Asked Questions

Are there good alternatives for Z-Pak (Zithromax)?

It depends on the type of infection! In general, there are many other antibiotic options that treat the bacterial infections that azithromycin is often used for. Your healthcare provider can help you figure out if an antibiotic is needed, and if azithromycin or another option is the correct choice.

Is azithromycin a steroid?

No. Azithromycin is a macrolide antibiotic that works by inhibiting the growth of bacteria.

Can Z-Pak be used to treat COVID-19?

No. Studies have shown that azithromycin does not treat COVID-19. COVID-19 is a viral infection, and azithromycin only treats bacterial infections. Azithromycin will not help with any viral illness, including COVID-19.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions,
and medical associations. We avoid using tertiary references.

• Azithromycin. (2021).
  https://www.ncbi.nlm.nih.gov/books/NBK548434/

• Azithromycin for community treatment of suspected COVID-19 in people at increased risk of an adverse clinical course in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial. (2021).
  https://www.thelancet.com/article/S0140-6736(21)00461-X/fulltext

• Doxycycline as an Alternative to Azithromycin in Elderly Patients. (2021).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779281/

• Use of antibiotics during pregnancy and risk of spontaneous abortion. (2017).
  https://pubmed.ncbi.nlm.nih.gov/28461374/

• Management of non-gonococcal urethritis. (2015).
  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-015-1043-4

• Effectiveness of azithromycin in aspiration pneumonia: a prospective observational study. (2014).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265472/

• Azithromycin for Elderly Patients With Pneumonia. (2014).
  https://jamanetwork.com/journals/jama/article-abstract/1910101

• Azithromycin and the Risk of Cardiovascular Death. (2012).
  https://www.nejm.org/doi/full/10.1056/NEJMoa1003833

• Diagnosis and Treatment of Acute Bronchitis. (2010).
  https://www.aafp.org/afp/2010/1201/p1345.html

• Newest Approaches to Treatment of Pelvic Inflammatory Disease: A Review of Recent Randomized Clinical Trials. (2007).
  https://academic.oup.com/cid/article/44/7/953/462098

• Single dose azithromycin for the treatment of uncomplicated otitis media. (2004).
  https://pubmed.ncbi.nlm.nih.gov/14770073/

• Is azithromycin the first-choice macrolide for treatment of community-acquired pneumonia? (2003).
  https://pubmed.ncbi.nlm.nih.gov/12746768/

• Randomized Double-Blind Study Comparing 3- and 6-Day Regimens of Azithromycin with a 10-Day Amoxicillin-Clavulanate Regimen for Treatment of Acute Bacterial Sinusitis. (2003).
  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC182642/

• Chlamydial Infection Among Adolescents and Adults. (2021).
  https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm

• Azithromycin versus penicillin V for treatment of acute group A streptococcal pharyngitis. (2002).
  https://pubmed.ncbi.nlm.nih.gov/12075761/

• Azithromycin-Containing Regimens for Treatment of Mycobacterium avium Complex Lung Disease. (2001).
  https://academic.oup.com/cid/article/32/11/1547/461472

• Azithromycin vs cefuroxime plus erythromycin for empirical treatment of community-acquired pneumonia in hospitalized patients: a prospective, randomized, multicenter trial. (2000).
  https://pubmed.ncbi.nlm.nih.gov/10809032/

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