Azithromycin has significant therapeutic effects on sensitive bacterial infections, especially respiratory and sexually transmitted diseases, but it needs to be used in a standardized manner and monitored after discontinuation. Its unique pharmacokinetics allow for short course treatment, but risks such as cardiac toxicity need to be managed throughout the entire process.

1. Evaluation of treatment efficacy

(1) Respiratory infection: The clinical cure rate for community-acquired pneumonia is 90%, and the 3-day treatment course is equivalent to the 10 day efficacy of beta lactams.

(2) Skin infection: The 5-day regimen has an effective rate of 85% for pustule disease, and the clearance rate of Staphylococcus aureus is better than that of clindamycin.

(3) Sexually transmitted diseases: The cure rate of non complex chlamydia infection treated with a single dose of 1g is 97%, which is recommended as a first-line treatment by the CDC.

2 Precautions for discontinuation of medication

(1) Standard treatment course: Most infections can be stopped after 3-5 days of prescription without the need for testing cure indicators.

(2) Symptoms persist: If there are still signs of infection such as fever after the course of treatment, a follow-up evaluation is needed to determine if dressing change is necessary.

(3) Special monitoring: For those who have been taking medication for more than 7 days, QT interval monitoring is still required for 1 week after discontinuation, especially when combined with cardiac medication.

3. Management after discontinuation of medication

(1) Diarrhea management: 20% of patients experience antibiotic associated diarrhea after discontinuing medication, and supplementing probiotics can shorten the course of the disease.

(2) Delayed onset of allergies: Severe rash may appear 72 hours after discontinuation of medication, and patients should be informed of warning symptoms.

(3) Liver function follow-up: For patients with a treatment course exceeding 10 days, it is recommended to stop taking the medication for 2 weeks before re examining ALT/AST.

4. Drug discontinuation guidelines for special populations

(1) Liver dysfunction: Even after completing the course of treatment, Child Pugh C patients still need to monitor their liver function until 1 month after discontinuing the medication.

(2) Pregnancy period: Continue to observe fetal heart rate until late pregnancy after discontinuing medication, animal experiments show potential risk of arrhythmia.

(3) Elderly people: It is recommended to maintain a hearing test for 2 weeks after discontinuing medication, especially for those with a history of exposure to ototoxic drugs.