Spectrum of Activity


General Information


  • Infuse over 1 hour (for 2mg/mL infusion) or 3 hours (1mg/mL infusion)


  • Reconstitute 500mg vial with 4.8mL of sterile water yielding 100mg/mL concentration
  • Further dilute to final concentration of 1mg/mL (500mL bag) or 2mg/mL (250mL bag) in NS, D5W or LR


  • D5W, LR, NS
  • Community acquired pneumonia
  • Pertussis
  • Upper respiratory tract infections
  • Chlamydial infections
  • Mycobacterial infections
  • Mycobacterium avium complex (MAC) prophylaxis in HIV patients

Tier One

  • Narrow spectrum, possible transition for discharge, IV to PO
  • Strategy: total EBM duration set (inpatient and outpatient)

Monitor QTc in patients with increased risk

LFTs and symptoms of hepatitis (malaise, N/V, abdominal colic, fever, yellowing of skin/eyes)

CBC with differential

  • Drug-induced liver injury
  • Diarrhea (monitor frequency and potentially test for C. diff. infection
  • Chest pain
  • Skin rash
  • Abdominal pain

Prolongation of QTc interval. Association with increased cardiovascular mortality in observational studies.

Prolonged half life may contribute to macrolide resistance.

  • Other drugs that prolong QTc
  • Increases cyclosporine levels
  • May increase digoxin levels
  • Statins increased risk of rhabdomyolysis

Antimicrobial class: Macrolide

Pregnancy category: B

Average serum half life: 68 hours

Urine penetration: Poor

Lung penetration: Therapeutic

CSF penetration: Poor

Biliary penetration: Therapeutic


Very high tissue penetration and concentration intracellularly means in vivo activity may not be predicted by in vitro testing - e.g. Salmonella species.