azithromycin / Generic mfg. - LARVOL DELTA

Effect of low dose azithromycin on the fecal microbiome and fecal bile acids in healthy dogs. (PubMed, J Vet Intern Med) - "Low-dose azithromycin induces a mostly reversible dysbiosis and reversible decrease in secondary fecal UBAs. Atypical decreases in Streptococcus abundance can also occur."

Journal

OPTIMUM SECOND-LINE REGIMENS FOR HELICOBACTER PYLORI ERADICATION: RESULTS OF A SYSTEMATIC REVIEW WITH META-ANALYSIS (UEGW 2026) - "Classical B quadruple therapy, with proton pump inhibitor (PPI)-metronidazole (M)- tetracycline (Tc), outperformed multiple comparators, including clarithromycin (C)-based and non-B regimens. Tc-containing therapies generally surpassed levofloxacin (L)-based regimens in direct comparisons, while L-based and some simplified regimens were associated with lower eradication rates. Following PPI-amoxicillin (A)-C triple therapy failure, PPI-B-M-Tc was significantly more effective than PPI-L-M triple therapy (RD=-0.16, 95%CI: -0.32, -0.01), and PPI-B-C-M quadruple therapy (RD=0.25, 95%CI: 0.07, 0.43)...Additionally, RBC-M-Tc triple therapy was superior to RBC-azithromycin dual therapy (RD=-0.32, 95%CI: -0.55, -0.10) and to PPI+B+M+Tc quadruple therapy (RD=-0.30, 95%CI: -0.52, -0.09)... The efficacy of second-line H. pylori therapies varies substantially depending on the initial regimen. B-based quadruple therapies, particularly PPI+B+M+Tc, were consistently the most effective..."

Retrospective data • Review • Infectious Disease

STATE-OF-THE-ART REVIEW: RECENT ADVANCES IN CAMPYLOBACTER GASTROENTERITIS (UEGW 2026) - "(predominantly C. coli with high tetracycline resistance) in U.S. swine feces and novel naturalized lineages in New Zealand freshwater with recombination-mediated loss of the cdtABC cytolethal distending toxin operon, suggesting attenuated human virulence...Management relies on supportive rehydration (oral or intravenous fluids), with macrolides—primarily azithromycin—reserved for severe, prolonged, or high-risk cases... Integrated One Health interventions encompassing enhanced biosecurity, bacteriophages, bacteriocins, and probiotics across poultry production chains are advocated to curb zoonotic spread. Promising prevention strategies include chemically synthesized C. jejuni capsular oligosaccharide conjugates, with the minimal disaccharide identified as a potent O-antigen candidate for vaccine development, alongside whole-genome sequencing for resistance surveillance. Nevertheless, critical gaps persist in distinguishing active infection from colonization, elucidating..."

Review • Gastroenterology • Gastrointestinal Disorder • Infectious Disease • CXCL8 • CYP1A1

ACUTE PANCREATITIS AS A DIAGNOSIS OF EXCLUSION: A RARE ASSOCIATION WITH CHLAMYDIA PNEUMONIAE (UEGW 2026) - "Azithromycin was initiated, with subsequent progressive improvement in symptoms and gradual normalisation of laboratory abnormalities during follow-up.Infectious causes account for ~10% of acute pancreatitis, and association with C. pneumoniae is exceptional...Therefore, this was considered a diagnosis of exclusion. The temporal association and resolution after antibiotic therapy support a possible causal relationship as an extrapulmonary manifestation of infection."

Cough • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Hepatology • Immunology • Infectious Disease • Musculoskeletal Pain • Pancreatitis • Pneumonia

Beyond lethal doses: sub-MIC levels of multi-class antibiotics induce species- and isolate-dependent biofilm inhibition in gram-negative pathogens. (PubMed, BMC Microbiol) - "This study demonstrates that sub-MIC exposure produces heterogeneous, antibiotic-, species-, isolate-, concentration-, and method-dependent biofilm responses that diverge between structural matrix accumulation and genomic abundance. Therefore, our findings highlight that sub-MIC exposures demand a multi-assay diagnostic framework to accurately evaluate biofilm-associated drug responses."

Journal • Infectious Disease • Pneumonia

Global Genomic Analysis Reveals Spatial Patterns and Temporal Trends of Priority-Antimicrobial Resistance in Salmonellaenterica Isolates from Aquatic Animals. (PubMed, Vet Sci) - "Globally, resistance to WHO-recommended clinically important antimicrobials showed substantial variation among antibiotic classes, with resistance rates for azithromycin (2.10%), cefepime (2.89%), cefotaxime (2.71%), ceftazidime (2.71%), and ceftriaxone (0.62%). Geographical differences were observed, with isolates from Asia exhibiting higher resistance levels, particularly for ciprofloxacin (13.50%) and doxycycline (18.02%)...A total of 111 acquired ARGs and 10 resistance-associated chromosomal mutations were identified, accompanied by changes in the distribution of resistance determinants. Collectively, this study provides a global genomic perspective on priority AMR in Salmonella from aquatic animals and highlights the importance of integrating aquaculture, environmental, and public health surveillance to monitor and mitigate AMR risks within the One Health framework."

Journal

Profound Hemolytic Anemia in Babesiosis With Lyme Disease Coinfection and Occult Strongyloidiasis. (PubMed, Cureus) - "The patient required intensive care monitoring and transfusion and improved following treatment with atovaquone, azithromycin, and doxycycline...This finding was clinically significant because warm autoimmune hemolytic anemia is a recognized complication of babesiosis and may require corticosteroid therapy, which can precipitate potentially life-threatening Strongyloides hyperinfection in patients with occult infection. This case highlights that severe babesiosis may occur despite low-level parasitemia and emphasizes the importance of recognizing coinfections and obtaining a detailed occupational and environmental exposure history, particularly when future immunosuppressive therapy may be considered."

Journal • Acute Kidney Injury • Anemia • Autoimmune Hemolytic Anemia • Critical care • Fatigue • Hematological Disorders • Immunology • Infectious Disease • Inflammatory Arthritis • Lyme Disease • Musculoskeletal Pain • Nephrology • Renal Disease • HP

Cardiotoxicity of macrolide antibiotics: a pharmacovigilance study integrating FAERS and JADER databases. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "Erythromycin showed the highest FAERS ROR for long QT syndrome (81.82, 95% CI 45.09-148.46), followed by azithromycin (34.71, 95% CI 25.15-47.91) and clarithromycin (18.11, 95% CI 8.61-38.08); azithromycin and clarithromycin signals were independently confirmed in JADER (ROR 24.42 and 13.17, respectively). Macrolide-associated cardiotoxicity extends beyond QT prolongation/TdP to heart failure and ischemic heart disease, with drug-specific and cross-national differences in signal pattern. As disproportionality signals, these findings are hypothesis-generating rather than causal, but support targeted cardiac monitoring in high-risk patients, particularly during the first 2 weeks of macrolide therapy."

Adverse events • Journal • Cardiovascular • Congestive Heart Failure • Coronary Artery Disease • Heart Failure • Myocardial Ischemia

Pseudotumoral donovanosis mimicking squamous cell carcinoma in a patient with HIV infection. (PubMed, Braz J Infect Dis) - "Despite prolonged antimicrobial therapy with azithromycin and doxycycline, followed by adjunctive acyclovir because of suspected chronic herpes simplex coinfection, the lesion continued to progress, raising concern for squamous cell carcinoma. Doxycycline was reintroduced and maintained until complete healing after four months. This case highlights the diagnostic challenges of pseudotumoral donovanosis in patients living with HIV."

Journal • Hematological Disorders • Herpes Simplex • Human Immunodeficiency Virus • Infectious Disease • Oncology • Squamous Cell Carcinoma

Agent, Dose and Duration: The Unanswered Questions Behind Latency Antibiotic Therapy for Preterm Prelabour Rupture of Membranes. (PubMed, Antibiotics (Basel)) - "Contemporary practice descends from two protocols: the ampicillin-erythromycin regimen of the NICHD Maternal-Fetal Medicine Units Network trial and the erythromycin arm of ORACLE I. Neither was designed to identify an optimal regimen. Substitution of azithromycin for erythromycin rests predominantly on observational cohorts together with one small open-label randomised comparison that pre-specified no non-inferiority margin and is therefore pragmatic and guideline-permitted rather than confirmed by an adequately powered randomised trial...Guideline agreement reflects shared historical ancestry rather than independent confirmation of optimality. Adequately powered pragmatic trials, stratified by gestational age, remain the principal unmet need."

Journal • Review • Infectious Disease • Obstetrics

Explainable Stacked Ensemble Learning for Predicting Antibiotic Residues in the Danube River Within the Territory of the City of Novi Sad, Serbia. (PubMed, Antibiotics (Basel)) - "Azithromycin was most prevalent (75.0%), followed by sulfamethoxazole (58.3%), trimethoprim, and ciprofloxacin (52.8% each), while wastewater generally exhibited broader antibiotic profiles and higher concentrations than surface water. Explainable STACK-RF modeling captured nonlinear, antibiotic-specific associations among residues, water-quality conditions, and microbial indicators. It may complement targeted chemical monitoring and support hypothesis generation, although larger, externally validated datasets are required before broader application."

Journal • Infectious Disease • Pneumonia

Systemic Antibiotics as Adjuncts in Periodontal Therapy for Stage III and Stage IV Periodontitis: An Umbrella Review Aligned with the 2018 World Workshop Classification, with AMSTAR-2 Critical Appraisal. (PubMed, Antibiotics (Basel)) - "and a systematic review by Jones and Hoyle focusing on azithromycin...reported moderate-certainty evidence that adjunctive amoxicillin plus metronidazole (AMX + MTZ) resulted in greater clinical attachment level gain and probing pocket depth reduction compared with mechanical debridement alone...Current findings support selective rather than routine antibiotic use, guided by individual patient and disease characteristics and antimicrobial stewardship. Future studies should emphasize long-term outcomes and consistently distinguish Stage III from Stage IV periodontitis."

Journal • Review • Dental Disorders • Periodontitis

Evaluation of Probiotic Properties and Antimicrobial Substances Produced by Five Lactic Acid Bacteria Against Foodborne and Spoilage Pathogens. (PubMed, Microbiologyopen) - "Four strains are resistant to multiple antibiotics but remain susceptible to azithromycin and tetracycline, while LP is resistant to all tested antibiotics. In conclusion, LAB strains demonstrated significant probiotic traits and the ability to produce AMS, especially BLIS, from four strains, with LP and LC showing the most potential. These findings support their application as natural biopreservation against MDR pathogens; however, further validation in the food system is required."

Journal

Toward Combating Pseudomonas aeruginosa Infection, the Creation of Azithromycin Derivatives Based on a Trojan Horse Strategy. (PubMed, ChemMedChem) - "aeruginosa activity. One of the derivatives showed superior antibacterial activity to AZM, even against MDR P. aeruginosa clinical isolates."

Journal • Infectious Disease • Inflammation

Genomic epidemiology of Salmonella Typhimurium in Guizhou, China (2019-2023): high prevalence of MDR, plasmid-associated resistance, and shared genomic lineages. (PubMed, Front Microbiol) - "Substantial resistance to first-line antibiotics was also observed, including ciprofloxacin (16.5%), ceftazidime (19.4%), cefotaxime (36.9%), and azithromycin (12.6%)...Resistance genotypes correlated well with phenotypes for azithromycin, ceftazidime, ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, and tetracycline (Kappa: 0.48-0.74)...These findings highlight the cross-regional and cross-species circulation of shared genomic lineages, suggesting complex ecological networks that may involve the food supply chain. Implementing an integrated "One Health" surveillance strategy is critical to track and limit the circulation of these resistant lineages and mitigate the associated public health threat."

Journal • Gastroenterology • Gastrointestinal Disorder

Two for the price of one: should donovanosis and chancroid be targeted for eradication? (PubMed, Sex Transm Infect) - "Chancroid is strongly associated with sex work: this is the tap that must be turned off. Where it remains endemic, sex workers' services should be supported to treat symptomatic cases, enhance condom use and deliver periodic presumptive treatment with azithromycin.Given their overlapping geographic distribution and the preponderant role of sex workers in transmission dynamics, an eradication programme could address both diseases simultaneously, with the same personnel."

Journal • Review • Gastroenterology • Immunology • Infectious Disease • Inflammatory Bowel Disease • Ulcerative Colitis

Antimicrobial resistance in Neisseria gonorrhoeae among men who have sex with men: a 10-year analysis with implications for doxycycline post-exposure prophylaxis. (PubMed, J Clin Microbiol) - "This finding raises concerns about the ongoing utility of dual ceftriaxone-azithromycin treatment. Furthermore, tetracycline resistance was significantly higher among doxyPEP users, with a disproportionate increase in high-level resistance (MIC >8 mg/L) that was associated with ciprofloxacin co-resistance. These findings provide timely real-world evidence to inform gonorrhea treatment guidelines and antimicrobial surveillance as doxyPEP implementation expands globally."

Journal • Human Immunodeficiency Virus • Infectious Disease

Hit and Run Hepatitis: Norovirus as a Potential Trigger for Seronegative Autoimmune Hepatitis (ACG 2026) - "Despite N-acetylcysteine, empiric antibiotics, and vitamin K, LFTs uptrended, and patient was transferred to liver transplant center...She was then transitioned to oral prednisone and discharged...Azithromycin induced liver injury was unlikely, as enzyme elevations occurred before its administration. Altogether, this case identifies norovirus as a potential AIH trigger and underscores the value of liver biopsy in seronegative cases."

Autoimmune Hepatitis • Hepatitis C • Hepatology • Immunology • Infectious Disease • Inflammation • Liver Failure • Novel Coronavirus Disease • Respiratory Diseases • CD8

An Enteric Impostor: Severe Campylobacter Ileocolitis Mimicking Crohn's Disease (ACG 2026) - "Biopsies demonstrated terminal ileitis and colitis with ulceration, cryptitis, crypt abscesses, and crypt distortion.â¯A 14-day course of azithromycin was continued upon discharge...Figure: Figure 1. Clinical course of severe campylobacter ileocolitis mimicking Crohn's disease"

Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hematological Malignancies • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Myelodysplastic Syndrome

The Hazy Brush Border: A Case of Intestinal Spirochetosis in a Patient With HIV (ACG 2026) - "He had received clindamycin for folliculitis but states his diarrhea preceded this. Loperamide was ineffective...He was treated with ciprofloxacin and azithromycin for E. Coli but his symptoms recurred following completion of each antibiotic...This case shows the importance of considering intestinal spirochetosis in the evaluation of chronic diarrhea, especially when other etiologies have been ruled out. Figure: Figure 1: Colonoscopy Biopsy Results Hematoxylin and Eosin Stain (A) and Warthin Starry silver stain (B) showing the "false brush border" characteristic of intestinal spirochetosis"

Clinical • Colonic Polyps • Diabetes • Gastroenterology • Gastrointestinal Disorder • Human Immunodeficiency Virus • Infectious Disease • Metabolic Disorders • Type 2 Diabetes Mellitus • ELANE

Persistent Pathogens: A Case of Chronic Enteropathogenic E. coli Diarrhea in an Adult (ACG 2026) - "Symptoms were partially controlled with dicyclomine and as needed hyoscyamine...Subsequent GI pathogen panel testing was positive for enteropathogenic Escherichia coli (EPEC) and sapovirus in the setting of persistent diarrhea, and the patient was treated with azithromycin 500 mg daily for three days...The patient was also co-infected with sapovirus, which may have increased susceptibility to persistent bacterial infection. Additionally, this case underscores the value of repeat infectious testing in patients with ongoing diarrhea despite initially negative studies."

Clinical • Autism Spectrum Disorder • CNS Disorders • Epilepsy • Genetic Disorders • Infectious Disease • Obesity • Obstructive Sleep Apnea • Respiratory Diseases • Sleep Disorder

Cytomegalovirus Colitis Unmasking Previously Undiagnosed Common Variable Immunodeficiency and Classic Hodgkin Lymphoma (ACG 2026) - "He was started on valganciclovir and chemotherapy with nivolumab. His course was further complicated by Campylobacter infection treated with azithromycin...In this case, CMV colitis initially appeared to explain the patient's gastrointestinal symptoms; however, persistent constitutional symptoms, profound hypogammaglobulinemia, and mediastinal lymphadenopathy prompted further evaluation that ultimately revealed cHL. This case underscores that CMV colitis in a young adult without an apparent cause of immunosuppression should prompt comprehensive evaluation for occult immunodeficiency and hematologic malignancy, as early tissue diagnosis is critical to avoid delays in definitive treatment and improve clinical outcomes."

Classical Hodgkin Lymphoma • Cytomegalovirus Infection • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Hodgkin Lymphoma • Immunology • Infectious Disease • Lymphoma • Primary Immunodeficiency

An Unfortunate Duo: Massive GI Bleed Due to Campylobacter Infection in an Individual With IgA Vasculitis (ACG 2026) - "The patient received pulse-dose intravenous methylprednisolone 500mg for 3 days and azithromycin, and was then transitioned to a prednisone taper with resumption of mycophenolate 500 mg twice daily with resolution of GI bleed. Figure: Figure 1: Images of patients palpable purpura on upper and lower extremities due to IgA vasculitis. Figure: Figure 2: Endoscopic findings of erythematous mucosa in the gastric fundus, body, and antrum."

Clinical • Cardiovascular • CNS Disorders • Gastrointestinal Disorder • Hematological Disorders • Immunology • Infectious Disease • Peptic Ulcer • Respiratory Diseases • Vasculitis

GI Bleeding in a Solid Organ Transplant Recipient (SOTR) from Disseminated Mycobacterium avium Complex (MAC) with Gastrointestinal Involvement: A Case Report (ACG 2026) - "He was treated with azithromycin, ethambutol, and rifabutin. Figure: Figure 1: Second and third portion of the duodenum characterized by coarsely granular and nodular appearance with diffuse congestion and friability. Figure: Figure 2A: H&E Stain: Duodenal mucosa with loss of villi and expansion of the lamina propria by foamy histiocytes (100x view) Figure 2B: Acid-Fast Stain: Lamina propria histiocytes containing numerous intracellular acid-fast bacilli, consistent with mycobacteria (200x view)"

Case report • Clinical • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Infectious Disease • Solid Organ Transplantation • Transplantation • IFNG

Multiloculated Liver Abscess Due to Klebsiella pneumoniae Requiring Right Hepatectomy in a Young Immunocompetent Patient (ACG 2026) - "He was initially evaluated elsewhere and discharged on azithromycin for presumed Mycoplasma infection...(C) CT abdomen/pelvis performed on October 21, 2025 following image-guided percutaneous drainage demonstrating persistent extensive multiloculated right hepatic abscess despite drain placement. (D) CT angiography of the abdomen obtained on October 24, 2025 demonstrating persistent large right hepatic abscess with extensive right lobe involvement prior to definitive surgical management with right hepatectomy."

Clinical • Anorexia • Cardiovascular • Hepatology • Hypertension • Infectious Disease • Inflammation • Liver Failure • Pneumonia