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The three pills | The three-day antibiotic: what it is and when it is prescribed

It is called azithromycin, although on the street – or in the office – the average person refers to it as ‘the three-day antibiotic’ or the ‘three pills’. In recent months his ‘fame’ in health centers has grown like foam thanks to word of mouth. “We have been prescribing it for many years, but it is true that it is increasingly known among patients and they themselves suggest it to us when we detect a mild bacterial process due to the convenience of finishing the treatment in just three days,” confesses one of the doctors. of family consulted by this newspaper. Of course, it goes without saying that the doctor has the last word, who only prescribes said ‘azithromycin’ in certain conditions in which its effectiveness has been demonstrated. We clarify doubts with this small guide in the form of questions and answers from Malaga doctors!:

What is azithromycin?

Azithromycin is a medication that works as an antibiotic and comes from the macrolide groupyes. It is generally used to combat ear and throat infections, but it can also have many other uses, for example to treat skin infections, nasal passages and other bacterial infections such as sexually transmitted diseases (gonorrhea or syphilis), pneumonia or pneumonias.

This is how it works

Azithromycin, like the rest of macrolides, acts by inhibiting the protein synthesis of bacteria. Its effect can be bacteriostatic (prevents the reproduction of the bacteria, which ages and ends up dying) or bactericidal (directly destroys the bacteria) depending on the bacterial species on which they act, size of the inoculum, the growth phase in the bacteria are found and the concentration that the antibiotic reaches at the site of the infection. Although it is administered for three days, the drug has a post-antibiotic effectthat is, after taking the last pill it remains in the body for a few more days, which takes time to completely eliminate it.

When is it prescribed?

Mostly, to combat mild to moderate respiratory infections in the upper tract (nose or throat). “It is prescribed when acting on more banal microbes but is not indicated for other more acute pathologies such as sinusitis that require more powerful drugs,” the doctors indicate while remembering that when it is a mere virus (cold or flu) , the use of antibiotics is not indicated. These are only prescribed when the condition is of bacterial origin. «What is happening this year, however, is that the flu – viral conditions – have arrived very strongly and have lasted too long. So much so that in many cases they end up leading to bacterial complications and causing respiratory infections,” they emphasize.

How is it taken?

The treatment includes three pills, which should preferably be taken at the same time. It should be taken on an empty stomach, that is, either one hour before eating or two hours after eating.. The reason is that the absorption of azithromycin can be reduced by the influence of food. The usual dose for an adult is 500mg/day for three consecutive days, that is, a total of 1.5g in 3 days. In children, 10 mg/kg of weight/day is usually prescribed in a single dose for three days. That is, a child weighing 10 kilos would take 100 mg in each daily intake.

Does it have side effects?

In general, It is a well tolerated drug. In fact, within the group of macrolides it is one of those with the lowest incidence of side effects. Most of those described are of mild or moderate intensity. Among the most frequent are: diarrhea, nausea, abdominal pain, headache, vertigo and increased transaminases.

False myths

Among many patients there is the mistaken belief that since the treatment is shorter – normally three days – the pills are more aggressive for the body. The doctors deny it: «They have a normal compound. There are those who ask us if ‘it’s a bomb’ because it lasts 3 days compared to 7 for amoxicillin, but it has no real basis,” they insist.