Azithromycin is a broad-spectrum antibiotic that’s commonly used to treat bacterial infections, like UTI, STIs and infections like strep throat. It is used ‘off-label’ for the treatment of diarrhea, including traveler’s diarrhea and other gastrointestinal infections caused by bacteria.
It belongs to a class of antibiotics called macrolides, which work by preventing bacteria from growing and multiplying. It’s particularly effective for severe diarrhea.[1]
How does Azithromycin work?
Azithromycin stops bacteria from making proteins they need to survive. It binds to the bacteria’s ribosomes (tiny protein-making machines) and blocks the production of essential proteins, which stops bacterial growth. Without these proteins, bacteria can’t spread further, allowing the body to fight off the remaining infection.
How long does Azithromycin take to work?
Azithromycin should start to reduce your symptoms within 24 to 48 hours after taking the first dose. You should start to have noticeable relief from your symptoms in the first 2-3 hours.
When it’s used in combination with another diarrhea medication, like Loperamide, it’s even faster. For example, in one study, people who took azithromycin with loperamide recovered in about 11 hours, compared to 34 hours for those who only took azithromycin.[1]
What doses of Azithromycin are there?
Azithromycin tablets come in doses of 250mg and 500mg. For bacterial diarrhea, the dose is typically 500mg a day for up to 3 days.
Your doctor will tell you which dose to use and how long to use it for.
Treated trusted source:
Tribble, D.R. (2017). Antibiotic Therapy for Acute Watery Diarrhea and Dysentery. Military Medicine, [online] 182(S2), pp.17–25.
This page was written by The Treated Content Team.
This page was medically reviewed by Dr Alexandra Cristina Cowell on January 24, 2025. Next review due on January 24, 2028.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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How to take Azithromycin
​​Azithromycin can be taken with or without food. Swallow the tablets whole with water.
Will Azithromycin cause any side effects?
Some of the most common side effects people get when using azithromycin include diarrhea, stomach pain, feeling sick (nausea), and headaches. Less common side effects can include dizziness, changes in taste, skin rashes, and fatigue​. Like all medications, the side effects people get can vary from person to person, and not everyone will experience them.[1]
In rare cases, azithromycin can cause serious side effects such as allergic reactions, including sudden swelling of the face, lips, or throat, difficulty breathing, or a severe skin rash with blisters. If you experience any of these symptoms, seek urgent medical attention immediately​.
The patient package insert (PPI) that comes with your medication contains a full list of possible side effects. You should read it carefully and speak to your doctor or pharmacist if you have any concerns while taking azithromycin.
Can you drink alcohol on Azithromycin?
Yes, you can drink alcohol on azithromycin. However, if you experience dizziness as a side effect of using azithromycin then you should avoid alcohol, as this will make your dizziness worse.
Can you take Azithromycin while pregnant?
Yes, you can take azithromycin during pregnancy, but only when it’s clearly needed and prescribed by a doctor. It’s commonly prescribed for infections such as sexually transmitted diseases, respiratory infections, and malaria during pregnancy.
While some studies have reported risks like miscarriage, preterm birth, and certain birth defects, others have not found any increased risk.[2] The evidence is inconclusive, so your doctor will weigh the benefits of treating an infection against any potential risks to the baby.
Treated trusted source:
Hopkins, S. (1991).Clinical toleration and safety of azithromycin. The American Journal of Medicine, [online] 91(3, Supplement 1), pp.S40–S45.
Antonucci, R., et al. (2022).Use of Azithromycin in Pregnancy: More Doubts than Certainties. Clinical Drug Investigation, 42(11), pp.921–935.
This page was written by The Treated Content Team.
This page was medically reviewed by Dr Alexandra Cristina Cowell on January 24, 2025. Next review due on January 24, 2028.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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Azithromycin isn’t suitable for everyone, and there are some things that you need to be aware of when taking it.
Here’s all the official info on it. If anything is unclear, let our clinician know, and they can talk with you about it.
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Azithromycin: FAQ
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
How effective is Azithromycin?
Answer:
Azithromycin is highly effective in treating bacterial diarrhea, especially in areas where bacterial resistance to other antibiotics is common. Studies show that it reduces the duration of diarrhea significantly and provides fast relief from symptoms.
One clinical trial involving people with traveler's diarrhea found that 96% of patients were 'cured' within 72 hours of one 1000mg dose of azithromycin.[1] When combined with diarrhea medications like loperamide, it can work even faster, shortening recovery time by almost two-thirds.
How is Azithromycin different from other treatments for diarrhea?
Answer:
There’s a few options available to treat diarrhea. Primarily you should focus on resting and rehydrating. Rehydration solutions are commonly used to help you replace the electrolytes and minerals you’ve lost through diarrhea. You can find these to buy over the counter in your local pharmacy or grocery store. Another option is antimotility medicines, like loperamide (you might have heard of its branded form, Imodium). These work by slowing down your food moving through the gut. Your body is then able to draw in more water through the intestine, helping your poop to become firmer.
Azithromycin is different because it's an antibiotic. Unlike the other options that just manage your symptoms, azithromycin actually targets the bacteria causing the diarrhea. There are other antibiotics available, like levofloxacin, but azithromycin is the preferred treatment. This is because it's proven effective for bacterial infections that cause diarrhea, even those that are resistant to other antibiotics.[1]
Do I need a prescription for Azithromycin?
Answer:
Yes, you will need a prescription for azithromycin, as it’s an antibiotic. You’ll need to talk to your doctor about your health and current medications to make sure it’s suitable for you before it can be prescribed.
If Azithromycin isn’t suitable for you, that’s okay. Our clinician can suggest alternative medicines that might be better suited to you.
Treated trusted source:
Tribble, D.R. (2017).Antibiotic Therapy for Acute Watery Diarrhea and Dysentery. Military Medicine, [online] 182(S2), pp.17–25.
Last updated on Jan 23, 2025.
How we reviewed this page:
Our experts continually monitor new findings in health and medicine, and we update our articles when new info becomes available.
Jan 23, 2025
Published by: The Treated Content Team.Medically reviewed by: Dr Alexandra Cristina Cowell, Writer & Clinical Content Reviewer
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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Dr Alexandra Cristina Cowell
Writer & Clinical Content Reviewer
Cristina writes content for Treated, and reviews content produced by our other writers to make sure it’s clinically accurate.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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