Talk:Azithromycin/Archive 1

Archive 1

Common therapy

I don't know who noted that a common dose was "two grams," but I've never seen anyone take more than 500 mg of azithromycin in one day for a typical infection. According to Lexi-Comp's Drug Information Handbook, 13th edition, the maximum dose for respiratory tract infections, soft tissue infections, and bacterial sinusitis is 500 mg daily, which is consistent with Pfizer and generic manufacturers packaging the tablets in blister cards of six 250 mg tabs (in America, anyway).

The two gram dose is only used for bacterial urethritis or cervicitis due to Neisseria gonorrhoeae, so I edited the article to reflect a more accurate typical course of therapy. Archmage Brian 02:12, 21 July 2006 (UTC)

Not sure this is "talk page" worthy, but this stuff cured my tonsillitis in like one minute 74.64.92.130 (talk) 11:41, 30 November 2007 (UTC)

Different Appearance

I'm on these now, just for a week. Just wanted to say that the description in the article doesn't quite match what my pills look like. Not sure if this has something to do with the above statement that they're now generic, but for the record, my pills are solid pink (not mottled), still oval shaped, and have '93' engraved on one side and '7146' on the other. They are the 250mg variety. These came from the Target pharmacy. I'd put this on the main page, but I think I'll let somebody who knows more about it make that decision. --Lurlock 17:02, 28 June 2006 (UTC)

Just want to add that as of today, late July 2008, they still have the pink pill appearance (I guess generic), with '93' on one side and '7146' on the other. BlinkerBoy (talk) 08:04, 30 July 2008 (UTC).

Your "93" and "7146" matches the Teva brand I just got in Nov 2010. Apparently they are made in Israel.

Not sure what generic manufacturer you've got, but Greenstone is the one our pharmacy carries. They look very much like the standard Pfizer tablets but obviously don't bear the company name and instead have a typical tablet identification number that corresponds to the drug's NDC or national drug code. Every azithromycin tablet I've seen has been, at the very least, oblong and pink, so I went ahead and made a clarifying note on the main page for you. Archmage Brian 02:18, 21 July 2006 (UTC)

Should someone say something about mechanisms of resistance for this drug (and what bacteria are more likely to be resistant)? I am not 100% sure, but if it is like with erythromycin there are three main resistance mechanisms: 1) prevention of entry into the cell via decreased permeability through membrane porins, 2) destruction of the lactone ring via an esterase, 3) methylation of the ribosomal target site (this one is usually plasmid mediated) ... -- Preceding unsigned comment added by Pietrocoen (talk • contribs) 00:40, 21 November 2007 (UTC)

Image of chemical structure may be wrong

I've gotten images of azithromycin from the original patent ("Compound V" in US #4,328,334) and from Google images. It looks like a methyl group is missing from one of the smaller rings in the Wikipedia image.

The image currently in the article matches the images at both PubChem and ChemSpider. Can you give an example of a different image, or can you elaborate on what exactly you think is wrong? -- Ed (Edgar181) 23:24, 9 January 2010 (UTC)

If this is the patent, then the current structure matches. Fvasconcellos (t·c) 00:11, 10 January 2010 (UTC)

I agree, "Compound V" in US patent 4,328,334 matches the structure in this article. -- Ed (Edgar181) 00:22, 10 January 2010 (UTC)

Sorry, I was complaining about the wrong page. THIS is the image that's wrong: http://commons.wikimedia.org/wiki/File:Azithromycin.png —Preceding unsigned comment added by 69.95.232.230 (talk) 21:17, 10 January 2010 (UTC)

That image was indeed incorrect. I have fixed it now. Thanks for catching the error and reporting it. -- Ed (Edgar181) 15:04, 11 January 2010 (UTC)

where is the formula???

there are stupid pictures of colorfull tablets and color boixes of the f\drug. WHERE IS THE FORMULA??? —Preceding unsigned comment added by 98.230.76.12 (talk) 15:48, 23 October 2010 (UTC)

Kinetics?

In the Pharmacokinetics section, there is this sentence: "Time to peak concentration in adults is 2.1 to 3.2 hours for oral dosage forms and 1 to 2 hours after a dose". Perhaps the "after a dose" was meant to be something like "after an intravenous dose"? —Preceding unsigned comment added by 98.227.72.10 (talk) 02:03, 25 November 2010 (UTC)

Ad copy

"With the macrolide technology of Zmax, this allows the drug to bypass the stomach, reducing gastrointestinal side-effects of high-dose azithromycin." Does this sound like ad copy to anyone else? — Preceding unsigned comment added by 71.108.147.51 (talk) 03:04, 30 May 2011 (UTC)

If you Google that in quotes it seems quite apparent to be ad copy. — Preceding unsigned comment added by 66.68.108.229 (talk) 19:30, 12 June 2011 (UTC)

Treating side effects

It would be helpful if more information could be provided on how to mitigate the drug's side effects, specifically: stomach pain, fatigue, and joint pain. PTCabe 17:36, 28 July 2011 (UTC) — Preceding unsigned comment added by Ptcabe (talk • contribs)

The only way is not to use Azithromycin. Seriously. Pubmed central says that Azithromycin changes about 500 genes in the human subject, some are switched on, some off, it thickens the mucus and acts antiinflammatory, changes lipid metabolism, acts on mitochondria and in some subjects invokes phospholipidosis faster than in others... You may thus notice strange effects, which however may take 10 days to clear off. (Still beats dying of infection like pneumonia). ((BTW: Strange blue light sensitivity increase on night vision could be seen, probably due to the phospholipidosis??.))

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923851/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528828/

Inconsistant IUPAC nomenclature

While checking Wikipedia reference for Azithromycin and Azitromicina (Spanish), I found the IUPAC descriptions quite different. Could just be a language issue I realize, but I thought the point of IUPAC standardization was to avoid this kind of problem? 201.229.226.193 (talk) 20:26, 14 September 2011 (UTC)Kevin Rollock Sept. 14, 2011

The problem is that IUPAC nomenclature isn't entirely standardized. The rules can be ambiguous and interpreted in different ways. The IUPAC name currently in this article matches the one given at ChemSpider, which is generally considered a reliable source. -- Ed (Edgar181) 20:45, 14 September 2011 (UTC)

Brand names

I don't think that long list of brand names belongs. It's of no use to the average reader, it's not linked to WP:RS, and it's easy to find the same information with a Google search.

It seems to violate WP:MEDMOS "Extract the pertinent information rather than just dumping low-level facts in a big list."

Does anybody have an objection if I remove it? --Nbauman (talk) 15:16, 26 October 2011 (UTC)

I think it would be a good idea to remove it. -- Ed (Edgar181) 15:19, 26 October 2011 (UTC)

Best-selling

Best-selling citation doesn't support the assertion that it is a world best-selling antibiotic. That's the article title, but could easily be just marketing fluff. What the text actually says is that Zithromax is one of the best-selling branded antibiotics in the US. Without any information on relative sales of branded vs. generics, one can't even infer that it's best-selling in the US, let alone the world. — Preceding unsigned comment added by 65.120.117.2 (talk) 21:05, 21 January 2013 (UTC)

Mention Yaws?

Could we mention the use of azithromycin in the yaws eradication campaign?HLHJ (talk) 17:51, 4 August 2015 (UTC)

Blacklisted Links Found on Azithromycin

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• http://www.ehow.co.uk/how_7369920_give-child-azithromycin.html

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Clinical language

We are specifically NOT a medical textbook. We can use normal and easy to understand language rather than clinical language. We are infact requested to do so by WP:MEDMOS in the lead. Thus summarized here [1] and left the further details in the body. Doc James (talk · contribs · email) 12:10, 16 December 2015 (UTC)

Pricing differences

Why is it so expensive? I got a pack of 6 Sumamed capsules a 250mg for throat inflammation and it cost me 4200HUF (half of which was reimbursed by social security). 4200 HUF is about 20USD or 1/12th of local monthly minimal legal wage. If I understand correctly antibiotics are fermented by the tonnes in railway cart sized tanks at pharma fabs so it should cost tuppence. 195.70.32.136 12:53, 15 February 2006 (UTC)

I can answer that question with two words: They're Greedy. 206.156.242.36 18:57, 3 April 2006 (UTC)

Zithromax 250mg, pack of 6 capsules, 19.27 euros in France, 2006 (75% to 100% reimbursed by social security). --PeaceAnywhere 17:34, 28 November 2006 (UTC)

Good deal. $49.99 retail price ($15.00 out of my pocket given my insurance) for the Greenstone 6 x 250mg version in the northeastern US. In areas of the world where most people are covered by health insurance (private or public) there's no reason for patients to shop around and thus little incentive for retail pharmacists to compete on price. --Sommerfeld (talk) 17:48, 21 December 2007 (UTC)

I just bought a 3 pack of 500mg in Hyderabad, India for 80 rupee or about $2 : January 2007. So the developed world is definately being gouged.

Drugs are sold with minimal or no profit in the developing countries, or even given away by pharmaceutical companies, so those of us in the developed countries have to pay extra. We are subsidizing the health care needs of the world's poor, which is not necessarily a bad thing.

$24.98 (USD) at my local Wal-Mart store in SW Iowa, USA for 3 pack 500mg of Generic Azithromycin manufactured by Sandoz. So prices seem to be dropping as of 2009. Cost me c. $35 last year from another local pharmacy, don't know if this is a price drop or just that the Evil That Is Wal-Mart has always been cheaper and i should have gone there before. -- Preceding unsigned comment added by 69.66.135.161 (talk) 15:58, 14 October 2009 (UTC)

I just got a 6-pack 250mg from Walgreens. They say the retail price of the Teva-branded product is $43.99, but my insurance co-pay is $10 (USD). —Preceding unsigned comment added by 98.227.72.10 (talk) 01:51, 25 November 2010 (UTC)

See price discrimination. It's great that pharmaceutical companies donate to the developing world, but as far as I know, they spend much more on marketing. If the amount the governments of the developed world spend on drugs could be even slightly reduced, the money could fund a lot of medical aid. I'm not sure how azithromycin is produced, or what the production cost per mg is; this would be excellent information to add to the article. HLHJ (talk) 18:37, 4 August 2015 (UTC)

I just bought a 6-pack of 250 mg Sandoz azithromycin at my local small-town pharmacy for $3.00. Perhaps you need to shop around a bit. John G Hasler (talk) 13:45, 20 May 2018 (UTC)

Good News about Azithromycin

Today (7 June 2006) I went to the pharmacy to get a prescription of the drug, and to my pleasant surprise, it was not a Pfizer product anymore. I think this indicates that the drug is now generic. As with any generic drug, the cost will go down now. My prescription was much cheaper (less than half) than the Pfizer product.

Well, the license Pliva granted to Pfizer certainly expired. Probably the patent, too... Had I not sold my Pliva shares, it wouldn't be good news for me :o) --bonzi (talk) 10:06, 5 February 2013 (UTC)

My MD prescribed azithromycin yesterday, ingested the first two tablets, an hour and a half later my ill feeling was gone, it was like a fog lifted from over me! Very surprised by the effectiveness of this medicine. HP Stehmer, Gettysburg, PA173.86.36.203 (talk) 19:36, 5 November 2013 (UTC)

Interesting, I can report that 500mg azithromycin dissolved in 0.4L water has this same effect in about 30 minutes! I mean, the fog lifting up... I wonder how that works... — Preceding unsigned comment added by 90.64.43.243 (talk) 17:50, 23 May 2018 (UTC)

Enhances Hunger

Just thought I would let you all know that I thought I was going mad because I stayed hungry, until I read the side effects of Zithromax and there is was this drug enhances hunger!!!.

Thanks goodness I took my last one today, now I can stop eating myself to death! -- Preceding unsigned comment added by 196.26.56.242 (talk) 12:00, 3 July 2008 (UTC)

Indented line

I HATE taking Azithromycin because it always makes my stomach feel like it's empty! Even after eating 2-3 meals worth of food. Because of this medicine, I once ate so much that I literally became sick to my stomach and vomited it all out. I never knew I was full! I have to eat small little snacks every half hour or the feeling drives me crazy! —Preceding unsigned comment added by 96.229.104.224 (talk) 04:51, 9 March 2011 (UTC)

I can report exactly the opposite, the reason is that Azithromycin makes your stomach feel "uneasy, irritated", if you can solve it by eating, good for you, for me it just stays the same. But other thing, I felt strong, even if I stopped eating. The reason is that Azithromycin changes some genes related to lipid processing, see Pubmed central for more. — Preceding unsigned comment added by 90.64.43.243 (talk) 17:53, 23 May 2018 (UTC)

500mg for 5 days or 3?

This source - http://www.drugs.com/pdr/azithromycin.html - claims the standard adult dosage is 500mg/day over 3 days, whereas the article has it at 5 days, citing the Physicians Desk Reference. Not having a copy handy, I can't check it against the original source to see if it's a typo or if my source is wrong. In either case, I'm one of the many adults who received a (mis?)prescription for 500+250x4. It's also still expensive - $43.99 for my 1500mg prescription, even as a generic. —Preceding unsigned comment added by 72.213.33.4 (talk) 22:54, 30 September 2010 (UTC)

Prescribed the Sandoz 250mg 6-pack. Filled the scrip @ Wal Mart. Pharmacist quoted $28, the amount I paid, without insurance was $15.60. Oval white pill with inscription of GGD6 on one side. Pharmacist said I could have a beer if I wanted, & it wouldn't interfere with the med. Just don't take with antacids. —Preceding unsigned comment added by 68.47.205.168 (talk) 18:01, 25 October 2010 (UTC)

Pubmed central says that the old version was 3 days at 500mg per day, but the new recommendation is 5 days due to gonorrhea bacteria promptly developping resistance to Azithromycin and 3 days leaves some Neiserria Gonorrheae behind. But for common nuisance infections 3 days should be good. For hazardous and resilient infections, longer time and antibiotic combinations may be the preferred choice. — Preceding unsigned comment added by 90.64.43.243 (talk) 17:56, 23 May 2018 (UTC)

Is it bitter if crushed and added to a food item?

I have a son with disabilities. He will not take pills. Meds colored, bitter tasting, and a who slu of other conditions :-)!!!! He was perscribed Azithromycin liquid and will not take it. Can anyone tell me if the pilss are cushable and ok to put into something like ice cream, pizza, yogurt -- or if you have any other food ideas to add to it that would be great. It's very strugling with a sick young man with disabilities. Please help. Thank you! 68.109.147.150 (talk) 21:43, 14 March 2012 (UTC)

Sumamed (Azithromycin) has dispersible tables and some sweetener and vanilla flavor, which, when dissolved in 0.3-0.4L of water can be easily drinked without noticing any strange taste. It is possibly due to the artificial sweeteners having a bitter aftertaste by themselves. — Preceding unsigned comment added by 90.64.43.243 (talk) 18:06, 23 May 2018 (UTC)

Z-Pak for Asthma, controversial?

Think you should take out the "controversial" portion of the azith helping to cure asthma until you can find a citation for it. I haven't been able to find anything online regarding it being controversial... — Preceding unsigned comment added by 66.64.112.204 (talk) 11:52, 2 April 2013 (UTC)

Pubmed central has a lot to say about Azithromycin and lung disease. It is because it "resets" the inflammatory response to antigens. Explanation: an overactive immune system will keep on attacking long after a threat is gone, Azithromycin caused the imflammatory response and white blood cell activity to appear only when active pathogen lyzate was injected. There are also nice pictures. anyone who finds it, can you post the link? (I closed it long ago) ), see Cystic Fibrosis comment below. Also, it changes the type and quantity of mucus production completely. — Preceding unsigned comment added by 90.64.43.243 (talk) 18:11, 23 May 2018 (UTC)

Ambiguity of 'Half-Life'

This very nicely written article contains:-

'According to Davis' Drug Guide for Nurses, following a single 500 mg dose, the half-life of azithromycin is 11–14 hours. The longer half-life of 68 hours is achieved only when multiple doses are consumed.'

For those not in the medical profession, 'half-life' as used in the second sentence is a bit ambiguous (if not shocking:-). It suggests multiple doses were consumed at once, which is unlikely. (I understood one chooses the size of the dose to be effective and spaces the doses to maintain a somewhat constant blood concentration.) A single word could eliminate any ambiguity. Geologist (talk) 04:21, 26 February 2012 (UTC)

I found out in the research that the half-life may be possibly extended with the amount of Azithromycin balled into phospholipids, specifically sphingolipids? The point was that life calls may react to high concentration of Azithromycin by storing it in phospholipid organelles and later slowly dispose of it when the human stops receiving the high doses. Thus the amount of Azithromycin in the human body over time will be non-linear (and not simply exponential decrease)... this may vary over different subjects.

I'll try to explain better: say that a single 200mg dose will not induce phospholipidosis and thus won't enter this long-term storage, but a 500mg dose will. Azithromycin is worldwide mostly made in 250mg and 500mg tablets, so for some the 500mg dose will be "a double dose". For stubborn infections, like those STDs, the concentration demanded would be even higher than a 500mg dose and thus you could see 1000mg or even higher single dose, most likely inducing even higher levels of phospholipidosis, so even higher amounts would be entering into long-term storage. That means that billiary or renal extrection is out of the question, as the antibiotic is stored in cell organelles and not in the blood stream or plasma. ...not to mention that Azithromycin switches on preference for fat storage. When the Azithromycin starts to leave this storage and how fast? There is little if any research on this. So the profile of "half-life" is hard to predict, but it's nice to know it is in days rather than hours. — Preceding unsigned comment added by 90.64.43.243 (talk) 18:46, 23 May 2018 (UTC)

Azithromycin also works as antifungal.

I am not a medical professional but i am dealing in medicine and writing this out of my personal experience. Azithromycin also acts as strong antifungal. I was suffering from candidisis of my toe nail. I know that if i take antifungal for candidisis of toe nail i will have to take antifungal for a long duration of time. I didn't take any medication for this because it did not create any problem. One month back i took Azhithromycin 500 mg twice daily for two days and 500 mg once daily for another three days for my tooth ache. Now i am noticing that the fungal infection of my toe nail has been cured and fresh nail is coming out. I have not taken any other medication for last 4-5 years and guess the fungal infection has been cured by azithromycin. I therefore request research prfoessionals to conduct further research on this aspect.... Sushil More — Preceding unsigned comment added by 203.81.165.109 (talk) 18:08, 20 June 2011 (UTC)

Wikipedia is not based on your personal experience (which is Original Research), but on scholary Reliable Sources. Cease and desist polluting the Talk Pages with stuff like this, which is of absolutely no benefit to the article. HammerFilmFan (talk) 14:06, 15 February 2015 (UTC)

"Cease and desist" orders do not further science, and a lot of research published on Pubmed Central strongly suggests and even proves that high doses (which 2000 mg of Azithromycin intake within 24-30 hours as described certainly is) produces effects far outside of simple macrolide antibiotic effect. I was searching for 10 minutes, but then I entered the SIMPLEST search phrase of "Azithromycin antifungal effect" into the search engine and here I present you with:

Potentiation of antifungal activity of amphotericin B by azithromycin against Aspergillus species. https://www.ncbi.nlm.nih.gov/pubmed/9447909

Susceptibility of Candida albicans biofilms to azithromycin, tigecycline and vancomycin and the interaction between tigecycline and antifungals. https://www.ncbi.nlm.nih.gov/pubmed/20685088

"Nguyen et al. [32] evaluated the efficacy of azithromycin–amphotericin B against Aspergillus species. The investigators demonstrated synergy against all 25 isolates tested. They also showed that the effect was attributable to a 70% inhibition of protein synthesis caused by azithromycin." https://academic.oup.com/cid/article/46/12/1889/298731

"Antifungal study: Azithromycin was not used as antifungal agent before, to the best of our knowledge; it is tested as antifungal agent for the first time along with its synthesized complexes. Surprisingly, all of the complexes and azithromycin showed excellent activity only against C. albican and did not exhibit any activity against F.solani, T. rubrub, A. purasiticus, A. effuris and S. cervicis. Post hoc ANOVA studies reveals that Mg(Azi)2, Co(Azi)2, Fe(Azi)2 , Zn(Azi)2 and Ca(Azi)2 complexes showed significant increase (p<0.001) in antifungal activity against C. albicans in comparison to azithromycin." https://www.omicsonline.org/open-access/synthesis-characterization-and-antimicrobial-activities-of-azithromycin-metal-complexes-2329-6798.1000133.php?aid=30719

There you have it... If I calculate Azithromycin concentration at the site of infection at 30-300ug/mL, and compare that to the MIC concentration of 4ug/mL for Candida Albicans shown in that study for pure Azithromycin, I can see that yes, Azithromycin DOES HAVE antifungal properties by itself, unluckily, it is finely effective only for poor old Candida Albicans. May you rest in peace, candida. So, the result of the "cease and desist order" has been these four fine links to scientific studies largely validating one stupid personal experience that means nothing. — Preceding unsigned comment added by 90.64.43.243 (talk) 19:43, 23 May 2018 (UTC)

Research sources

Things like these: Anti-viral effects against Rhinovirus, due to the mucus genes changes to the great disadvantage of the virus: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923851/

Drug Induced Phospholipidosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528828/ This needs to be mentioned! Phospholipidosis changes the understanding of the treatment and poses unknown dangers (which may be also lethal to the pathogens). Other link to phospholipidosis, with pictures. It discusses the possible mechanism of action and consequences. https://febs.onlinelibrary.wiley.com/doi/full/10.1016/j.febslet.2006.08.061 — Preceding unsigned comment added by 90.64.43.243 (talk) 20:03, 23 May 2018 (UTC)

Other links on Pubmed Central (like above, but not inserted here) talk about how Azithromycin concentration in some white blood cells is 40x (that is 3900% greater) than in the plasma concentration. Which means that Azithromycin in very great molar concentrations is transferred by chemotaxis of the white blood cells towards the infective agents, greatly enhancing its effects. Intracellular pathogens can somewhat evade this effect. Like someone in the talk page mentioned, it explains why the treatment of Azithromycin acts so fast and so effective on the lymph nodes.

Next: foamy --macrophages--? Due to the high Azithromycin amount, some white blood cells can become very deformed and bloated. Either way, they carry the load towards the infective agent, like a ticking bomb... vey nice.

It also should be mentioned that Azithromycin is the only Azalide antibiotic in existence and that it is not a typical macrolide, it is different from the other macrolides and thus the profile of the other macrolides will not completely copy the interesting effects of Azithromycin. ((like, 200mg of Erythromycin has no effect on some infection, while 500mg of Azithromycin acts significantly within first 3 hours...)) — Preceding unsigned comment added by 90.64.43.243 (talk) 18:30, 23 May 2018 (UTC)

Please see WP:MEDRS Doc James (talk · contribs · email) 23:58, 23 May 2018 (UTC)

Please Check Your Sources

The article says

In the United States it is about US$33 for a course of treatment.[2]

[2] says

  "Azithromycin". The American Society of Health-System Pharmacists. Archived from the original on 2015-09-05. Retrieved Aug 1, 2015.

But the link actually goes to this drugs.com page

   https://www.drugs.com/monograph/azithromycin.html

Which has a link to a pricing page which makes it clear that $33.26 is the price for a powder preparation for the mixing of IV doses. I just paid $3.00 for 6 250 mg tablets (a full course of treatment for the most common uses) at my local small-town pharmacy. At least look at the other prices on that page (and correct the citation). John G Hasler (talk) 23:54, 16 May 2018 (UTC)

Yes thanks User:John G Hasler will switch to this source.[2]Doc James (talk · contribs · email) 00:00, 24 May 2018 (UTC)

Cystic Fibrosis

Azithromycin is also used chronically in cystic fibrosis patients over the age of 6 who are colonized with pseudomonas. The mechanism here involves the anti-inflammatory properties of azithromycin, not the antibacterial properties. — Preceding unsigned comment added by Radpotato (talk • contribs) 11:29, 30 November 2015 (UTC)

Possible effects of Azithromycin on mitochondria

Could Azithromycin's action on the 50s ribosomal subunit cause mitochondrial effects? If so, is there any effect on the body's aerobic capacity? I tried to do some research, but nothing came up. — Preceding unsigned comment added by 76.10.46.117 (talk) 06:50, 5 November 2011 (UTC)

Search again, there is some info now on Pubmed Central. One of the effects is the gene changes, look for the ones you are interested in, but it switches on or off a lot of genes related to lipid metabolism, some possibly due to the phospholipidosis it induces (thus the gene change may be due to the defensive reaction against the azithromycin). It should be in the research related to the anti-inflammatory effects of macrolides, if my memory serves me right. — Preceding unsigned comment added by 90.64.43.243 (talk) 18:34, 23 May 2018 (UTC)

Mitochondria react by saving energy, switching to glykolysis where necessary, stopping protein synthesis (= not using energy for protein synthesis) "Metabolic inhibitors and antibiotics have always affected the proliferation of PHO in lower concentrations than the metabolic activity, but the reverse is true for MG63 and HeLa cells. Both MG63 and HeLa cells are transformed immortalized stable cell lines which mainly aim to proliferate. Even if they were short of energy, they maintained their growth rate first of all, whereas the nontransformed and highly specialized primary human osteoblasts reacted differently by reducing cell proliferation and saving energy first. The reaction of PHO, and probably of other primary cells as well, reflects much better the reaction of normal body tissue on substances influencing energetics than do cell lines." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1797653/

"From plants to mice and human cells, tetracyclines lead to mitochondrial dysfunction in model organisms." https://www.the-scientist.com/?articles.view/articleNo/42414/title/Widely-Used-Antibiotics-Affect-Mitochondria/ "Across four commonly used human cell lines, as little as 1 microgram of the drug per milliliter resulted in a decrease in cellular respiration, signaling impaired mitochondrial activity."

Macrolides have the mitochondrial suppression effect much lesser than tetracyclines, but contradicts the above on cell respiration (on different tissue types tested, however): "Of these eight, kasugamycin, lincomycin, clindamycin, streptomycin, azithromycin, and erythromycin had little or no effect on mitochondrial protein synthesis from either tissue, with IC50s of >400 μM. Tetracycline was most inhibitory with IC50s of 2.1 μM in both heart and liver, while the IC50s of chloramphenicol were 9.8 and 11.8 μM in heart and liver, respectively. None of the antibiotics tested had any effect on mitochondrial respiration or coupling." http://aac.asm.org/content/50/6/2042.full — Preceding unsigned comment added by 90.64.43.243 (talk) 02:50, 24 May 2018 (UTC)

Antibiotics as a future part of cancer treatments?

"Antibiotics that target mitochondria effectively eradicate cancer stem cells, across multiple tumor types: Treating cancer like an infectious disease" Some combination of cancer cell types, conditions, antibiotic and concentrations had very remarkable effects. Other were less effective, or not effective at all at lesser concentrations, while very effective at high concentrations. Some had linear effect depending on concentration.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4467100/

What is remarkable that it states that the study started because doctors noticed better survival rates at people with similar cancer states, who for any reason were also taking antibiotics. The very marked difference in effects when comparing the combinations also points out that for this to have a practical meaning is to know exactly the cancer cell type, as for the two/three breast cancer cells had a different response profile. — Preceding unsigned comment added by 90.64.43.243 (talk) 02:56, 24 May 2018 (UTC)

Again please see WP:MEDRS Doc James (talk · contribs · email) 21:45, 24 May 2018 (UTC)

Incorrect information

• The article says that azithromycin contains phagocytes. This can't be true.
• Pricing doesn't seem correct either as $4 for three 500mg pills is too low. It costs at least €10 in medium expensive European countries.
• The brand names section does not mention any brands, but only other medicines that might be prescribed with azithromycin. — Preceding unsigned comment added by 93.109.187.61 (talk • contribs) 14:01, 8 June 2018 (UTC)

Re: Incorrect information

I recently paid $3.00 for six 250 mg pills at a small-town pharmacy in the rural USA. John G Hasler (talk) 17:04, 24 January 2019 (UTC)

COVID-19 source reliable?

The source stating azithromycin is effective against COVID-19 references an article in Int J Antimicrob Agents that doesn't actually exist. See DOI link here, says not found. I've never heard of "Mediterranee Infection". Are we sure this is a reliable source? 142.79.198.243 (talk) 17:31, 19 March 2020 (UTC)

There you go: International Journal of Antimicrobial Agents Special Issues: COVID-19 Therapeutic and Prevention Note: The article in question, page 105949 isn't there at time being 84.249.25.224 (talk) 23:27, 19 March 2020 (UTC)

I'm aware that the journal exists, thanks. I'm talking about the actual article, which as you said does not seem to exist. I don't understand what you mean by "at time being" - either an article is published or it's not. An article that isn't published isn't a reliable source. 142.79.198.243 (talk) 01:32, 20 March 2020 (UTC)

Not "at time being" but "for time being", my bad. Names Gautret and Colson produce lots of published hits, also mentioning azithromycin in an unrelated way in another COVID-paper https://doi.org/10.1016/j.ijantimicag.2020.105932 and Méditerranée-Infection is mentioned in their papers and the new paper is mentioned in French-speaking front page of mediterranee-infection.com. So I would say the research has been done by (atleast previously)respected people and paper is real, but is not(atleast yet) published in peer review journal. For general good the paper may be worth mentioning in the wiki-article but wording should be up to date about unclear situation of the paper. Now the mentioning seem to be removed. — Preceding unsigned comment added by 84.249.25.224 (talk) 06:46, 20 March 2020 (UTC)

We need sources per WP:MEDRS Doc James (talk · contribs · email) 00:06, 30 March 2020 (UTC)