Azithromycin 250mg tablets in a 6-tablet pack provide flexible dosing for various bacterial infections. This macrolide antibiotic offers a 5-day treatment course with once-daily dosing, maintaining therapeutic tissue concentrations for 5 days post-treatment. The pack is ideal for respiratory infections, skin conditions, and pediatric dosing (for children ≥45kg). Each tablet delivers reliable absorption with 37% bioavailability, reaching peak plasma concentrations in 2-3 hours.
The 6-tablet pack (total 1500mg) is approved for: mild-moderate community-acquired pneumonia (500mg Day 1, then 250mg Days 2-5), acute bacterial sinusitis, and streptococcal pharyngitis. It shows 92% efficacy against Chlamydia pneumoniae respiratory infections. Pediatricians use this strength for children ≥45kg (10mg/kg daily for 5 days). Compared to erythromycin, it offers better GI tolerance and less frequent dosing. Recent IDSA guidelines recommend it for pertussis prophylaxis and mycobacterial infections.
Standard adult dosing: 500mg (2 tablets) on Day 1, then 250mg (1 tablet) daily for 4 more days. For children ≥45kg: 250mg once daily for 5 days. Swallow whole with water - may take with food to reduce nausea. Space antacids by 2 hours. Renal impairment: No adjustment needed. Hepatic impairment: Reduce dose in severe cirrhosis. Complete full course even if symptoms improve earlier. The pack provides exact count for 5-day treatments.
Azithromycin inhibits bacterial protein synthesis by binding to 50S ribosomal subunits. The 250mg strength achieves tissue concentrations 10-50x higher than plasma, with 68-hour half-life. Effective against S. pneumoniae (85% susceptible), H. influenzae, M. catarrhalis, and atypicals (Legionella, Mycoplasma). Resistance mechanisms include efflux pumps (mef genes) and ribosomal methylation (erm genes), with current resistance <15% for respiratory pathogens.
Common effects: diarrhea (8%), nausea (5%), abdominal pain (3%). Serious risks: QT prolongation (0.2%), hepatotoxicity (monitor LFTs), and C. difficile infection. Contraindications: macrolide allergy, history of cholestatic jaundice. Black box warning for potential fatal arrhythmias. Caution in elderly, cardiac patients, and those with electrolyte imbalances. Discontinue if hearing changes, irregular heartbeat, or severe skin reactions occur.
Children: Approved for ≥6 months (use suspension under 45kg). Pregnancy: Category B (safe when needed). Elderly: Monitor QT interval. Hepatic impairment: Reduce dose if severe. Myasthenia gravis: May worsen weakness. HIV patients: Increased cryptosporidiosis risk. No renal adjustment needed for 5-day courses.
The 250mg 6-tablet pack allows precise 5-day dosing versus loose tablets. Compared to 500mg 3-tablet packs: more flexible pediatric/adult dosing but slightly more pills. Versus clarithromycin: better once-daily dosing and tissue penetration. Cost is comparable to other azithromycin formats ($10-$20 without insurance). The 250mg strength is preferred for pediatric step-down dosing and patients needing lower per-dose amounts.
Store at 20-25°C (68-77°F) in original blister packs. Protect from moisture - keep desiccant in bottle. Tablets remain stable until expiration (typically 3 years). Once removed from packaging, use immediately. Travelers should use moisture-proof containers. Never use if tablets are discolored or crumbling.
Generic 6-tablet packs cost $8-$25 retail. Most insurance plans cover with $0-$15 copay. Medicare Part D typically requires no prior authorization. The WHO Essential Medicines List includes azithromycin. Cost-effective due to high compliance and low monitoring needs compared to alternatives like levofloxacin.
Take at same time daily, with or without food. Complete all tablets to prevent resistance. Report diarrhea, dizziness, or palpitations. Space antacids by 2 hours. Not for viral infections. Women: Use backup contraception. Store properly - don't transfer to pill organizers. Keep out of humidity.
Current studies: 3-day regimens for otitis media, combination therapy for MAC, and anti-inflammatory effects in COPD. Resistance concerns: 50% in N. gonorrhoeae, <10% in S. pneumoniae. Research continues on optimal dosing for obese patients and new extended-release formulations.
Increases digoxin levels (monitor toxicity). Avoid with pimozide/ergotamine. Antacids reduce absorption (space 2 hours). May potentiate warfarin (check INR). Cyclosporine levels may rise. No food restrictions. Caution with other QT-prolonging drugs.
This 1500mg total dose (6x250mg tablets) is typically prescribed for: mild-to-moderate respiratory infections (like bronchitis), otitis media in children, and prolonged treatment of chlamydial infections. The extended 5-day regimen provides sustained antibiotic coverage.
• Day 1: 500mg (2 tablets) as loading dose
• Days 2-5: 250mg (1 tablet) daily
• Take at same time each day, 1 hour before or 2 hours after food
• Maintain 2-hour gap from antacids/iron supplements
• Complete full course even if symptoms improve
The initial 500mg loading dose quickly achieves therapeutic blood levels, while subsequent 250mg doses maintain effective concentrations in infected tissues. This mimics IV-to-oral step-down therapy protocols.
1. More flexible for pediatric dosing (weight-based calculations)
2. Enables precise dose adjustments for renal impairment
3. Preferred for elderly patients needing lower daily doses
4. Allows gradual tapering in sensitive patients
5. Tablets may be scored for splitting (check manufacturer)
This 5-day course provides: longer tissue penetration for stubborn infections, lower daily peaks (reducing GI side effects), and better tolerance in vulnerable populations. The total cumulative dose (1500mg) remains identical to the 3-day protocol.
• Watch for new-onset diarrhea (especially bloody)
• Report any palpitations or dizziness
• Monitor liver function in prolonged use
• Check for oral thrush or vaginal yeast
• Assess respiratory symptoms daily