Azithromycin: Antibiotic and not only...

Antibacterial therapy is an essential component of treatment for bacterial respiratory infections. The last decade has seen an increase in resistance of respiratory pathogens to different classes of antibiotics. The purpose of this review was to analyze publications on azithromycin, a macrolide with both antibacterial and non-antibacterial properties. Studies conducted worldwide indicate heterogeneity in both the frequency of azithromycin use and resistance to it, but in general, there is an increase in the values of its minimum inhibitory concentration against pathogens for which the use of macrolides is indicated. The COVID-19 pandemic has led to an expansion of clinical experience with the use of this azalide, demonstrating sufficient safety of the drug. However, recent large retrospective studies have shown the inappropriateness of its etiotropic use in this viral infection, limiting it only to proven cases of bacterial pneumonia caused by pathogens sensitive to macrolides. One of the ways to optimize the use of azithromycin is its combined use with other drugs that provide synergy in clinical effectiveness. An important property of azithromycin, ensuring its clinical effectiveness, is its ability to affect inflammatory processes in the respiratory tract, the state of the respiratory epithelium. The anti-inflammatory properties of azithromycin are used in various fields of medicine, including traumatology, gynecology and dentistry. The clinical effectiveness of antibiotics is determined by their rational use, patient compliance and convenience of the dosage form. In this regard, work is underway to create forms convenient for oral administration, to overcome the bitter taste. In this direction, certain successes have been achieved by domestic developers in the introduction of a dispersible form of azithromycin.