"Can you cure it by taking it at home?" Is azithromycin really that magical?

Review expert: Gu Haitong, deputy chief physician of respiratory medicine department, Beijing Tongren Hospital, Capital Medical University

Since the second half of this year, especially since students started school in September, there have been many cases of infection with Mycoplasma pneumoniae. It is mainly transmitted through respiratory droplets, with an incubation period of 1 to 3 weeks, and the incidence rate among adolescents is very high.

Many posts similar to "Heal at home and get rid of Mycoplasma pneumonia" have appeared in many parent groups. They mainly talk about how to heal Mycoplasma pneumonia at home. Azithromycin is listed as the first one. Many parents trust it very much, and some cautious parents will verify some of the statements.

Recently, many official authorities have also recommended azithromycin, so more parents feel at ease letting their children take it, and even recommend it to parents they know. Word spreads, and parents begin to stock up on medicine for their children. For a time, azithromycin on the market was sold out, and even out of stock on major platforms.

Source | A drug purchasing platform

So, in the face of "cough" and "pneumonia", can we buy azithromycin and take it on our own? Is this medicine safe? This starts with the source of infection of this disease.

1

What is Mycoplasma Infection?

Mycoplasma pneumoniae is the smallest known pathogenic microorganism that can survive independently, between bacteria and viruses. It has no cell wall and invades cells and proliferates after infecting the human body, inhibiting the metabolism of infected cells and leading to the death of infected cells. It can cause lower respiratory tract infections, which are especially common in children and young adults .

Azithromycin and other drugs are the first choice for the treatment of Mycoplasma pneumonia infection. In February this year, the National Health Commission issued the "Guidelines for the Diagnosis and Treatment of Mycoplasma Pneumonia in Children (2023 Edition)", which clearly stated that mycoplasma pneumonia (MPP) is the most common community-acquired pneumonia in children aged 5 years and above in my country. In terms of drug treatment, macrolide antibiotics are the first choice for the treatment of MPP, including azithromycin, clarithromycin, erythromycin, roxithromycin and acetyl kitasamycin.

Among them, azithromycin is the preferred choice . It is a new macrolide antibiotic with a wide therapeutic range. It is a short-course, simple, efficient and promising oral antibacterial drug. It is also a very common antibiotic. However, before taking it, we still need to understand the basic information about azithromycin.

2

Why is azithromycin the first choice?

There are so many drugs for treating respiratory infections nowadays, why do people choose azithromycin as the first choice?

Azithromycin is commonly used to treat inflammatory diseases such as upper respiratory tract, urinary system and skin infections. It mainly acts on the ribosomes of bacteria and can inhibit the growth of Gram-positive bacteria, Gram-negative bacteria, fungi and other pathogens, with significant therapeutic effects.

Azithromycin is a very effective antibacterial agent. It can bind to the ribosomes in bacterial cells, blocking the activity of peptidyl transferase, inhibiting the transpeptidation process of bacteria, inhibiting the growth and reproduction of bacteria, and thus playing an antibacterial role. It also has a good anti-inflammatory effect, can effectively relieve the patient's pain, fever and other symptoms, and has a good therapeutic effect on fever and other symptoms caused by mycoplasma pneumonia.

Source | A drug purchasing platform

But why can't the well-known cephalosporin antibiotics be used to treat mycoplasma infection? Cephalosporin antibiotics are a class of broad-spectrum antibiotics that can be used to treat a variety of bacterial infections. However, Mycoplasma pneumoniae is a bacterium without a cell wall, and the mechanism of action of cephalosporin antibiotics is to kill bacteria by inhibiting bacterial cell wall synthesis . Therefore, cephalosporin antibiotics are ineffective for treating microorganisms such as mycoplasma.

Children are the most susceptible group to mycoplasma pneumonia. The main reason why this group is susceptible to mycoplasma infection is that children's lung immune defense is still in the construction stage, the immune system is not yet mature, and the non-specific and specific immunity of the respiratory tract is poor. For example, the nasal and airway ciliary movement and cough reflex are weak, and the levels of immunoglobulins IgA and IgG are low.

Therefore, for children who are prone to mycoplasma pneumonia, azithromycin is the first choice drug with low side effects and good efficacy.

3

Precautions when using azithromycin

All medicines are toxic. Although azithromycin is a very common antibiotic, in recent years, the resistance of Mycoplasma pneumoniae to macrolide antibiotics has begun to attract people's attention. Excessive use will produce drug resistance, reduce the treatment effect, and is not conducive to the subsequent treatment of pneumonia.

When using azithromycin, you need to understand the disease it mainly affects - Mycoplasma pneumoniae infection (not all mycoplasma infections can cause pneumonia). Its main symptoms are fever and cough. The initial symptom of cough is paroxysmal dry cough, which may cause sputum . Some people may also experience chest pain, sore throat, headache and other symptoms. A few people may even experience cyanosis and difficulty breathing. If such symptoms occur, do not take medication on your own and go to the hospital for treatment in time.

Source | pexels

Mild cases of mycoplasma pneumonia can usually be controlled after treatment with macrolide antibiotics such as azithromycin, but the cough may continue for about 2 weeks after the body temperature returns to normal . The pneumonia shadows on the chest X-ray can basically be absorbed, so there is no need to recheck the chest X-ray.

Before using azithromycin, ordinary families must carefully read the drug instructions to understand the method of use, time of use, contraindications and other related information. In addition to the common gastrointestinal irritation reaction, azithromycin has certain liver damage. Patients with liver function-related diseases or liver damage must use it with caution. In addition, azithromycin allergies also exist.

During the use of azithromycin, the condition should be continuously monitored. If symptoms such as shortness of breath or severe allergic reactions occur, stop taking the drug immediately and seek medical attention immediately. Home treatment must be strictly carried out according to the instructions of the doctor or pharmacist. Do not increase the dosage or duration of use of the drug without authorization to avoid side effects caused by drug abuse or drug resistance.

Special reminder: for respiratory infectious diseases such as Mycoplasma pneumonia, it is still necessary to focus on prevention, stay away from pathogens, try to avoid crowded enclosed places, wear masks, wash hands frequently, strengthen exercise, and improve immunity.