Azithromycin For Strep: Dosage, Side Effects and Usage

Sick Woman Having Sore Throat, Tonsillitis, Feeling Sick
Medically reviewed by Dr. Ola Tarabzuni

Key Takeaways

  • Strep throat is an infection caused by Bacterium Streptococcus Pyogenes and presented with a set of discomforting symptoms including sore throat, and swollen tonsils/lymph Nodes.
  • Penicillin is the choice of drug/first line of treatment for strep throat. Azithromycin comes second with more effectiveness in those having penicillin allergy or resistance.

Overview

Do you know what sucks? Runny nose with difficulty in swallowing even with the slightest change in weather. Well! That can be hell tricky to understand whether you are allergic or you started to develop strep throat.

Let’s start understanding this by the basic term used when we try to get the medication for our sore throat and difficulty swallowing, strep-throat.

Strep throat is an infection caused by the bacterium streptococcus pyogenes which presents with similar symptoms of viral sore throat, runny nose and nausea. A person can catch this bacteria if exposed to such a surface or environment having streptococcus bacteria. Examples may include touching such surfaces and then touching back to your nose and mouth or when sharing utensils with a person already suffering from a strep throat infection. 

You might have heard of the cute candy-like antibiotic with the name “Z-pak” and was prescribed immediately for strep throat for 5 days. Let’s tear into this Z-PAK EASY TO-GO Medication for strep throat in a bit of detail.

What Is Azithromycin or Z-Pak?

Azithromycin, commonly known as Z-Pak, is a macrolide antibiotic used to treat various bacterial infections. It is particularly effective in treating pneumonia, sinusitis (sinus infection), and ear, nose, and throat infections. 

Azithromycin is often prescribed as a second-line treatment for strep throat caused by Streptococcus. The first line of treatment is usually Penicillin. However, due to allergies and resistance to penicillin in some individuals, azithromycin has become the preferred alternative. Amoxicillin is another common and effective antibiotic for treating strep throat, often used when Penicillin is not suitable.

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How to Treat Strep Throat With Azithromycin?

Strep throat can be treated effectively 100% by azithromycin macrolide antibiotic as It will inhibit its further growth and stops the bacteria from further affecting you. Its starting dose is 500mg on the first day ( 2 tablets of 250mg) and 250 mg each day for the rest of the 4 days. It’s a total 5 days course of azithromycin to totally eradicate the symptoms and soreness you feel.

Usage of Azithromycin

First approved by the Food and Drug Administration (FDA) in 1991, Azithromycin is prescribed to treat:

Adhere to the prescribed dosage and duration when using Azithromycin to treat strep throat. This practice is known as “antibiotic compliance,” which means completing the full course of medication, even if you start feeling better after a few days. Azithromycin is typically taken for five days for strep throat: two tablets on the first day, followed by one tablet daily for the next four days.

Compliance with the prescribed antibiotic regimen is essential to prevent the development of antibiotic resistance. If you stop taking Azithromycin too soon, the bacteria may not be fully eradicated and can become resistant to the medication. This resistance makes it harder to treat the same infection in the future, necessitating different, potentially more potent antibiotics.

By ensuring full compliance with the antibiotic course, you help prevent the spread of resistant bacteria and ensure the effectiveness of Azithromycin in treating strep throat.

Dosage of Azithromycin

When azithromycin is prescribed for strep throat, pharyngitis, or tonsillitis, the dosage varies depending on the patient’s age and weight.

Adults

The typical dosage for adults is 500 mg on the first day (loading dose), followed by 250 mg once daily for the next four days. This regimen totals a five-day course with a cumulative dose of 1,500 mg.

Children and adolescents

The dosage for children is generally based on body weight. The typical pediatric dose is 12 mg/kg on the first day (not to exceed 500 mg), followed by 6 mg/kg once daily on days 2 through 5.

Infants and young children:

For infants and young children, the dosage is also weight-based. A common regimen is 10 mg/kg on the first day, followed by 5 mg/kg once daily on days 2 through 5.

General guidelines

Azithromycin can be taken with or without food. However, if the medication causes stomach irritation, taking it with a meal is advisable to reduce discomfort. By adhering to the prescribed dosage regimen and understanding the importance of compliance, patients can effectively treat strep throat and reduce the risk of antibiotic resistance.

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When Should You Seek Medical Attention?

By the time you start feeling difficulty in swallowing or pain in your throat, it’s good to get yourself checked by a healthcare practitioner or go to the lab for a rapid strep swab test.

Other symptoms of strep throat are fever, swollen tonsils, white pus on tonsils and swollen lymph nodes should not be ignored. 

FAQs About Azithromycin For Strep

How fast does a Z-Pak work for strep throat?

Z-pak can treat strep throat in under 5 days if the prescribed dosage is 250mg daily. The recovery window varies from person to person depending upon their immunity and the severity of the infection. 

Are antibiotics always necessary to treat strep throat?

Yes, antibiotics are the only way to treat strep throat. It’s a bacterial infection with discomforting symptoms that can only be treated with the right antibiotics. Other than antibiotics, some natural remedies can help ease symptoms. For instance, drinking warm liquids, gargling with warm salt water, and drinking black pepper tea can help immensely.

When is the best time to take azithromycin?

Antibiotics like azithromycin can be taken in the morning or night with or without a meal. There is no specific time to take azithromycin. However, taking antibiotics at the same time of the day till it’s prescribed can help greatly in getting better.

Is azithromycin the only antibiotic used to treat strep throat?

No, Strep throat is a bacterial Infection caused by the bacterium streptococcus. It can be treated with Penicillin (the first line of treatment) and amoxicillin other than azithromycin. However, the antibiotic your provider prescribes depends on the patient’s medical history and infection.

Can azithromycin be taken with other medications?

No, Azithromycin can not be tolerated with all medications. For instance, antivirals, including nelfinavir, can not be taken with azithromycin. It also interacts with antacids, anticoagulants, and SSRIs. It’s better to tell your healthcare provider about all the medications you plan to take before starting an azithromycin prescription.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Casey JR, Pichichero ME. Higher dosages of azithromycin are more effective in treatment of group A streptococcal tonsillopharyngitis. Clin Infect Dis. 2005 Jun 15;40(12):1748-55. doi: 10.1086/430307. Epub 2005 May 13. PMID: 15909262.
  • Schaad UB, Kellerhals P, Altwegg M; Swiss Pharyngitis Study Group. Azithromycin versus penicillin V for treatment of acute group A streptococcal pharyngitis. Pediatr Infect Dis J. 2002 Apr;21(4):304-8. doi: 10.1097/00006454-200204000-00009. PMID: 12075761.
  • Medscape. Strep Throat: Where Does Azithromycin Fit?
  • Centers for Disease Control and Prevention. Pharyngitis (Strep Throat)
  • Mayo Clinic. Azithromycin (Oral Route)
  • McMullan BJ, Mostaghim M. Prescribing azithromycin. Aust Prescr. 2015 Jun;38(3):87-9. doi: 10.18773/austprescr.2015.030. Epub 2015 Jun 1. PMID: 26648627; PMCID: PMC4653965.
  • Food and Drug Authority. Azithromycin (marketed as Zithromax or Zmax) Information

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