Nurse Teaching Topic: Side Effects of Azithromycin Use

1. Nausea and vomiting: This is the most common side effect of Azithromycin. Taking the antibiotic with some food and water can minimize the effects of nausea and vomiting.
2. Diarrhea: Human intestines have a lot of bacteria, both good and bad, living in a sensitive balance with each other. This helps maintain the normal natural intestinal environment. Azithromycin works by killing the bacteria. While doing this, Azithromycin does not differentiate between good and bad bacteria. Consequently, apart from killing the bad infectious bacteria, Azithromycin also kills the good bacteria in the intestinal system, thus compromising the balance between good and bad bacteria. This can result in reduction in the number of good bacteria and increase in the number of Azithromycin resistant bad bacteria, leading to irritation of the intestinal mucosa and diarrhea. Diarrhea secondary to the clostridium difficile bacteria in the intestines, is a standard example for this.
3. Renal damage: Long term Azithromycin intake can lead to renal damage, thus compromising kidney function. Renal injury and altered kidney function can result in increased creatinine levels in the body, accumulation of other wastes resulting in altered levels of consciousness, and reduced urine formation.
4. Opportunistic fungal infections: The friendly normal flora residing in the human body help prevent growth of opportunistic infections. Azithromycin by destroying the normal flora, tips the balance in favor of opportunistic infections. So, long term use of Azithromycin carries a risk of opportunistic fungal infections, such as, thrush and yeast infections.
5. Anaphylaxis: A rare, but serious anaphylactic response can occur for Azithromycin. Patients can present with extreme itching and rash, swelling of the face and throat, dizziness, bronchoconstriction, and difficulty breathing. This is an emergency and medical attention should be sought immediately, without any delay.
6. Cardiac arrhythmias: Azithromycin can precipitate irregular heartbeats, life-threatening ventricular arrhythmias in individuals with history of cardiac arrhythmias. Individuals with history of chronic disturbance in serum magnesium and potassium ions are also at increased risk for arrhythmias with Azithromycin. Also, individuals taking Lasix are at increased risk for losing potassium, thus setting the ground for life-threatening arrhythmias, upon taking Azithromycin.