General Information

  • Urethritis/cervicitis: Chlamydia and gonorrhea (in combination with 3rd gen cephalosporin)
  • Pertussis
  • Nontuberculous mycobacteria*: prophylaxis (advanced HIV infection) and treatment (in combination with other medications)
  • Bartonella infections
  • Legionella infections


  • Bacterial COPD exacerbation
  • Acute otitis media
  • Bacterial conjunctivitis
  • Pelvic inflammatory disease (in combination)
  • Salmonella, Shigella, traveler’s diarrhea
  • Cesarean section (non-elective) prophylaxis
  • Prolonged QTc interval and Torsades de Pointes
  • Potential for drug-drug interactions
  • Prolongation of QTc interval. Association with increased cardiovascular mortality in observational studies.
  • Diarrhea (5%)
  • Rare cytopenias
  • Increased liver enzymes

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
  • Very high tissue penetration and concentration intracellularly means in vivo activity may not be predicted by in vitro testing - e.g. Salmonella species.
  • Due to its long half life and very high tissue penetration, more than 5 days of therapy is rarely required

Antimicrobial class: Macrolide

Pregnancy category: B

Average serum half life: 68 hours

Urine penetration: Poor

Lung penetration: Therapeutic

CSF penetration: Poor

Biliary penetration: Therapeutic