Azithromycin And Alcohol

Even when azithromycin is exactly what is needed for treating an infection, not everyone should have it. One of the most significant drug interactions with azithromycin (Zithromax) antibiotic is alcohol, that is wine, beer, and spirits used as a beverage.

Whether you drink or not, of course, this drug doesn't kill all kinds of bacteria. It is used for treating infections with Gram-positive bacteria, microbes that have a kind of tough protein lining, such as staph, strep, and Klebsiella. However, it continues to kill these bacteria whether or not your drink. The problem is, when you use azithromycin, your liver becomes much more susceptible to damage by alcohol. If you are a heavy drinker, especially if you have alcoholic cirrhosis of the liver, if you have hemochromatosis (iron-overload disease), if you have either acute or chronic viral hepatitis, or if you have a disease called pancreatitis, you simply cannot drink if you use azithromycin (Zithromax or Z-Pack). However, if you can manage not to drink while you are on this drug, alcohol-related peptic ulcers may spontaneously improve.

See Also: Antibiotics & Alcohol: The Truth And Myths

There are other applications of azithromycin that you probably won't find in a casual search of the Internet:

• People who have chronic obstructive pulmonary disease (COPD) or chronic bronchitis are less likely to suffer respiratory infections if they take azithromycin as a preventive measure. (Erythromycin has a similar effect.) Sometimes antibiotic treatment has the unexpected result of improving quality of sleep. However, no one should take the antibiotic for more than 6 to 12 months at a time to avoid developing antibiotic-resistant infections.
• Azithromycin is often the first treatment of choice for cat-scratch fever, a sometimes serious infection caused, as its name suggests, by scratches from cats. A cat scratch can transmit microorganisms that can cause serious damage to the spleen.
• The World Health Organization has arranged for mass distribution of a single dose of azithromycin (instead of the usual five) to eradicate a tropical disease called yaws. This condition begins as a hardening of the skin 2 to 5 cm (about 1 to 2-1/2 inches) in diameter. The skin breaks open and forms an ulcer. The ulcer eventually heals, but later more skin lesions appear with destruction of the joints. Just a single dose of azithromycin offers enough protection to prevent "oozing" of the ulcer stage so that the disease is not passed from child to child.
• Many American doctors prescribe a Z-Pack (five tablets of azithromycin) as a preventive measure for traveler's diarrhea. This usually isn't a good idea, because the medicine then could not be used to treat the more severe cases of "invasive" infections that can be caused by waterborne bacteria. It is better to make sure you wash your hands before you eat, to avoid salads, untreated water, and uncooked food. Anything you take to stop diarrhea before it occurs actually traps disease bacteria in your body and can make you sicker. The best approach to traveler's diarrhea is treatment, not prevention.