Azithromycin Injectable: Dosing and Precautions
Azithromycin injectable guidance for severe macrolide-sensitive infections when oral treatment is not possible.
Also searched as
Source reviewed
June 2025
Guide category
Injectable drugs
Safety boundary
Prescription medicine information for clinician-guided use.
Kenza Health Hub presents this medicine page as structured health education. Check dose, route, interactions, pregnancy or breast-feeding considerations, and local protocol with a qualified clinician or pharmacist. Read our medical editorial policy.
Therapeutic action
Macrolide antibacterial.
Indications
Macrolide-sensitive severe infections, when oral administration is not possible, such as sepsis and diphtheria.
Forms and strengths, route of administration
- Powder for injection, in 500 mg vial, dissolved in 4.8 ml of water for injection, for IV infusion in 0.9% sodium chloride or 5% glucose.
- Do not administer by IV or IM injection.
Dose
Dilute each dose to obtain a final concentration of 2 mg/ml and administer over 60 minutes.
Sepsis
- Child: 10 to 20 mg/kg, maximum 500 mg, once daily.
- Adult: 500 mg to 1 g once daily.
Diphtheria
- Child: 10 to 12 mg/kg, maximum 500 mg, once daily.
- Adult: 500 mg once daily.
Duration
Change to oral treatment as soon as possible.
Contra-indications, adverse effects, precautions
- Once reconstituted, the solution must be used immediately; discard any unused open vial.
- Do not administer to patients with allergy to azithromycin or another macrolide, nor to patients with severe hepatic impairment.
- Administer with caution to children under 6 weeks of age and to patients with risk factors for QT prolongation.
- May cause gastrointestinal disturbances, reversible hearing disorders, electrolyte disturbances, QT prolongation, severe hypersensitivity reactions, and life-threatening hepatotoxicity.
- Avoid combination with drugs that prolong the QT interval.
- Administer with caution and monitor use in patients taking digoxin.
- Pregnancy and breast-feeding: no contra-indication.
- Do not mix with other drugs in the same infusion.
Source
MSF Essential drugs practical guidelines (January 2026)
This page combines source-derived medicine reference sections with Kenza editorial context, while leaving out the Storage and Remarks sections from the source batch.
Rate this guide
Be the first to rate this guide.