Always prioritize asthma control with inhaled corticosteroids as the cornerstone of treatment. Azithromycin should be considered only as an adjunctive therapy for specific situations.
Reserve azithromycin for children with persistent asthma exacerbations despite optimal inhaled corticosteroid therapy and who exhibit features suggestive of an underlying infection, such as increased sputum production or wheezing unresponsive to bronchodilators.
Before prescribing azithromycin, thoroughly assess the child’s history for potential allergies and drug interactions. Obtain a complete medication list, including over-the-counter medications.
Monitor for potential adverse effects, including gastrointestinal disturbances like nausea and diarrhea, and liver function abnormalities. Regular blood tests may be necessary for children receiving prolonged courses.
Consider alternative therapies such as montelukast or omalizumab before resorting to azithromycin, especially for long-term management.
Always document the specific clinical rationale for azithromycin prescription in the patient’s medical record. This includes the severity of asthma, response to other therapies, and clinical signs suggesting infection.
Regularly reassess the need for continued azithromycin therapy. If asthma symptoms improve, consider tapering or discontinuing the antibiotic to minimize potential long-term risks.
Follow recommended dosage guidelines based on the child’s weight and age, strictly adhering to the prescribed duration of treatment. Avoid exceeding the recommended dosage or duration.
Educate caregivers about the proper administration of azithromycin and potential side effects. Emphasize the importance of adherence to the prescribed treatment plan and reporting any adverse events.
Recognize that azithromycin is not a substitute for good asthma management practices, including regular inhaler use, allergen avoidance, and prompt treatment of acute exacerbations.
