Azithromycin for Chlamydia

Azithromycin is a generic, prescription-only antibiotic that’s used to treat certain bacterial infections, such as:

• certain sexually transmitted infections (STIs), such as chlamydia
• chest or throat infections
• some ear infections
• traveller’s diarrhoea

The active ingredient in the medication is azithromycin dihydrate.

Azithromycin is no longer recommended as a first-line treatment for chlamydia because research shows that chlamydia is becoming resistant to azithromycin. This is also the case for mycoplasma, another organism sometimes present with chlamydia.

Antibiotic resistance occurs when bacteria change and develop to survive antibiotics, making infections more difficult to treat.

The current recommended first-line treatment for chlamydia is doxycycline. Azithromycin is one of the alternative treatment options for chlamydia.

Doxycycline belongs to a class of antibiotics called tetracyclines. When you are prescribed doxycycline, you’ll need to take a 7-day course, consisting of one 100mg tablet, twice a day. You can find out more about doxycycline by reading the patient information leaflet.

If you’re not pregnant, the options for treating chlamydia in order are:

1. Doxycycline
2. Azithromycin
3. Ofloxacin

If you are pregnant, the options are:

1. Azithromycin
2. Erythromycin or amoxicillin

Azithromycin works by killing off the bacteria that causes chlamydia, preventing it from growing and spreading. This helps your body to clear out the chlamydia infection.

Azithromycin takes up to 3 days (72 hours) to clear a chlamydia infection. Even if you start feeling better or see a reduction in symptoms, it is important that you finish the complete course to make sure it is effective and that all the bacteria have been killed off.

When taken correctly, azithromycin is effective in treating chlamydia in more than 95% of cases. You must complete your full course of azithromycin to make sure the medication is effective and completely clears your infection.

While azithromycin can effectively treat chlamydia, it is no longer the recommended first-line treatment due to rising antibiotic resistance, which is making azithromycin a less effective option.

Doxycycline is the first-line treatment recommended for treating chlamydia. Clinical trials have shown that doxycycline is a more effective treatment than azithromycin. One study found that doxycycline cured 95.5% of rectal chlamydia infections, compared to 78.5% with azithromycin. The same study found that doxycycline cured 95.4% of vaginal chlamydia cases, while azithromycin cured 93.5%.

To treat chlamydia, you need to take azithromycin for 3 days. You take 1000mg of azithromycin on the first day, and then you take 500mg of azithromycin on the following 2 days.

You should swallow the azithromycin tablets whole, with a glass of water, and you can take them with or without food. You can take your azithromycin tablet at any time of the day, but you should take it at the same time each day.

You should avoid taking any indigestion medications for 2 hours before or after taking azithromycin.

Azithromycin is a prescription-only medication so you will need to get a prescription from your doctor to obtain it.

Can I buy azithromycin online?

Yes, you may find that some providers still prescribe azithromycin for chlamydia online. However, this is not the recommended first-line treatment for chlamydia. ZAVA only prescribes doxycycline for chlamydia.

Can I buy azithromycin over the counter?

No, azithromycin is a prescription-only medication, so you will need to get a prescription from your doctor and cannot buy it over the counter.

Can I get azithromycin on the NHS?

Yes, it may be possible to get azithromycin on the NHS, but you will need to make an appointment with your doctor or visit an STI clinic for a prescription following a positive chlamydia test result.

Very common azithromycin side effects (may affect more than 1 in 10 people) include:

• abdominal pain
• diarrhoea
• loose wind (flatulence)
• feeling sick (nausea)

Common azithromycin side effects (may affect 1 in 10 people include):

• feeling dizzy
• headache
• lack of appetite
• deafness
• visual impairment
• being sick (vomiting)
• stomach cramps, or problems with digestion
• skin rash and itching
• joint pain
• change in the quantity of white blood cells and the concentration of bicarbonate in the blood
• fatigue
• changes to the sense of taste

Uncommon azithromycin side effects (may affect up to 1 in 100 people) include:

• respiratory problems such as chest pain, breathlessness, wheezing, and cough
• thrush
• bacterial infection of the throat
• pneumonia
• hypersensitivity
• reduced sense of touch
• nervousness
• dizziness
• spinning sensation
• hot flushes
• constipation
• dry mouth
• mouth ulcers
• belching
• allergic skin reactions
• liver problems
• dry skin
• inflammation of the skin
• muscle pain
• increased sweating
• pain, swelling and reduced movements in the joints
• back pain
• neck pain
• increased blood urea levels
• pain or discomfort when urinating
• weakness
• skin being more sensitive to the sun than usual
• urticaria
• testicular disorder
• swelling of the extremities (peripheral oedema)
• generally feeling unwell

Rare azithromycin side effects (may affect 1 in 1000 people) include:

• feeling agitated
• feeling unreality to the self and own feeling
• allergic skin reactions
• sudden appearance of red skin rashes
• swelling of the hands, lips, genitalia, or throat
• abnormal hepatic function
• kidney problems

You can find a full list of azithromycin side effects in the patient information leaflet.

How long do azithromycin side effects last

Most azithromycin side effects should go away on their own as your body gets used to the medication or within a week of stopping the treatment. That’s because it takes 3 days to clear about half the azithromycin dose from your body, so some side effects can last for about a week until the medication has left your body completely.

What to do if you get azithromycin side effects

If you experience any of the common azithromycin side effects, they can usually be managed at home. Be sure to drink plenty of water, get some rest, and take over-the-counter painkillers if necessary. It is safe to take azithromycin with paracetamol and ibuprofen.

If you experience any of the following serious allergic reaction side effects while taking azithromycin, you should call 999 or go to A&E:

• sudden difficulty breathing, speaking, or swallowing
• swollen lips, tongue, face, and neck
• extreme dizziness or collapse
• severe or itchy skin rash
• serious skin reactions such as blistering

Azithromycin may not be suitable for everyone – certain conditions or medications can interact with azithromycin and make it less effective or potentially unsafe.

Do not take azithromycin if you are allergic to any of its ingredients.

Talk to your doctor before taking azithromycin if you:

• have ever had a serious allergic reaction that has caused any swelling to the face or throat, and may have been accompanied by breathing problems, rash, fever, swollen glands, or an increase in eosinophils (certain types of white blood cells)
• have developed severe or persistent diarrhoea during or after treatment
• have severe heart problems
• have low levels of potassium or magnesium in your blood
• start to show signs of any other infection
• have myasthenia (a certain type of muscle weakness)
• are taking any ergotamine derivatives to treat migraine
• have any nervous (neurological) or mental (psychiatric) problems

Before you start to take azithromycin, tell your doctor if you are or have taken any other medications, including:

• antacids
• cholesterol-lowering tablets
• aarfarin
• hydroxychloroquine
• cisapride
• terfenadine
• zidovudine
• rifabutin
• quinidine
• cyclosporin
• alfentanil
• theophyline
• digoxin
• astemizole
• pimozide

If any of the above apply to you, you may be given an alternative treatment, such as doxycycline for chlamydia.